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Mother with post-partum group B Streptococcus meningitis and cerebellar abscess

Ghani NA, Jaafar R, Ishak S, Zainuddin AA, Mukari SA, Mahdy ZA

J Obstet Gynaecol Res, 2007 Apr;33(2):195-8.
PMID: 17441895

We report the case of a 25-year-old Malay woman, admitted for preterm delivery at 35 weeks' gestation. Vaginal swab did not isolate any organism. She delivered a baby girl who developed respiratory distress syndrome, requiring ventilation. Although chest radiograph showed hyaline membrane disease with pneumonia, septic workout was negative. The mother was discharged on the next day. Seven days postpartum, the mother presented with fever and fits and was diagnosed to have meningo-encephalitis. Lumbar puncture isolated group B Streptococcus (GBS) and MRI revealed a superior cerebellar abscess. She was treated and survived the episode. This case illustrates the uncommon situation where GBS infection was confirmed via maternal septic workout rather than neonatal, although both presented with severe disease.

Matched MeSH terms: Meningitis, Bacterial/epidemiology*
Fulltext Risk factors for Streptococcus suis infection: A systematic review and meta-analysis

Rayanakorn A, Goh BH, Lee LH, Khan TM, Saokaew S

Sci Rep, 2018 09 06;8(1):13358.
PMID: 30190575 DOI: 10.1038/s41598-018-31598-w

Streptococcus suis (S. suis) is a gram-positive bacterial pathogen in pigs which can cause serious infections in human including meningitis, and septicaemia resulting in serious complications. There were discrepancies between different data and little is known concerning associated risk factors of S. suis. A systematic review and meta-analysis was conducted to investigate on S. suis infection risk factors in human. We searched eight relevant databases using the MeSH terms "Streptococcus suis" OR "Streptococcus suis AND infection" limited in human with no time nor language restriction. Out of 4,999 articles identified, 32 and 3 studies were included for systematic review and meta-analysis respectively with a total of 1,454 Streptococcus suis cases reported. S. suis patients were generally adult males and the elderly. The mean age ranged between 37 to 63 years. Meningitis was the most common clinical manifestation, and deafness was the most common sequelae found among survivors followed by vestibular dysfunction. Infective endocarditis was also noted as among the most common clinical presentations associated with high mortality rate in a few studies. Meta-analyses categorized by type of control groups (community control, and non-S. suis sepsis) were done among 850 participants in 3 studies. The combined odd ratios for studies using community control groups and non-S. Suis sepsis as controls respectively were 4.63 (95% CI 2.94-7.29) and 78.00 (95% CI 10.38-585.87) for raw pork consumption, 4.01 (95% CI 2.61-6.15) and 3.03 (95% CI 1.61-5.68) for exposure to pigs or pork, 11.47, (95% CI 5.68-23.14) and 3.07 (95% CI 1.81-5.18) for pig-related occupation and 3.56 (95% CI 2.18-5.80) and 5.84 (95% CI 2.76-12.36) for male sex. The results were found to be significantly associated with S. suis infection and there was non-significant heterogeneity. History of skin injury and underlying diseases were noted only a small percentage in most studies. Setting up an effective screening protocol and public health interventions would be effective to enhance understanding about the disease.

Matched MeSH terms: Meningitis, Bacterial/epidemiology*
Fulltext A risk scoring system for predicting Streptococcus suis hearing loss: A 13-year retrospective cohort study

Rayanakorn A, Katip W, Goh BH, Oberdorfer P, Lee LH

PLoS One, 2020;15(2):e0228488.
PMID: 32017787 DOI: 10.1371/journal.pone.0228488

BACKGROUND: Streptococcus suis (S.suis) is an emerging zoonosis disease with a high prevalence in Southeast Asia. There are over 1,500 cases reported globally in which majority of cases are from Thailand followed by Vietnam. The disease leads to meningitis in human with sensorineural hearing loss (SNHL) as the most common complication suffered by the patients. Early diagnosis and treatment is important to prevent severe neurological complication. In this study, we aim to develop an easy-to-use risk score to promote early diagnosis and detection of S.suis in patients who potentially develop hearing loss.
METHODS: Data from a retrospective review of 13-year S.suis patient records in a tertiary hospital in Chiang Mai, Northern, Thailand was obtained. Univariate and multivariate logistic regressions were employed to develop a predictive model. The clinical risk score was constructed from the coefficients of significant predictors. Area under the receiver operator characteristic curve (AuROC) was identified to verify the model discriminative performance. Bootstrap technique with 1000-fold bootstrapping was used for internal validation.
KEY RESULTS: Among 133 patients, the incidence of hearing loss was 31.6% (n = 42). Significant predictors for S. suis hearing loss were meningitis, raw pork consumption, and vertigo. The predictive score ranged from 0-4 and correctly classified 81.95% patients as being at risk of S.suis hearing loss. The model showed good power of prediction (AuROC: 0.859; 95%CI 0.785-0.933) and calibration (AuROC: 0.860; 95%CI 0.716-0.953).
CONCLUSIONS: To our best knowledge, this is the first risk scoring system development for S.suis hearing loss. We identified meningitis, raw pork consumption and vertigo as the main risk factors of S.suis hearing loss. Future studies are needed to optimize the developed scoring system and investigate its external validity before recommendation for use in clinical practice.

Matched MeSH terms: Meningitis, Bacterial/epidemiology

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