Abstract
Group B streptococcal infections among non-pregnant adults have dramatically increased over the past two decades. Most infections involve skin/soft tissue infections and bacteremia, but whether more unusual clinical manifestations due to this organism will arise in clinical practice remains unclear. This report is the first case in the literature of a sporadic, large intra-abdominal abscess due to group B Streptococcus in an immunocompetent adult. Given the rising number of invasive group B streptococcal infections among adults, unusual presentations of this organism may increasingly be seen in clinical practice. This report reviews the literature regarding invasive group B Streptococcus infections, including intra-abdominal/pelvic abscesses, and discusses the clinical presentation and management of this emerging pathogen.
References
Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB, Hadler JL, Danila R, Cieslak PR, Schuchat A. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med. 2000;342:15–20.
Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S, Craig AS, Schaffner W, Zansky SM, Gershman K, Stefonek KR, Albanese BA, Zell ER, Schuchat A, Schrag SJ. Epidemiology of invasive group B streptococcal disease in the United States, 1999–2005. JAMA. 2008;299:2056–65.
Skoff TH, Farley MM, Petit S, Craig AS, Schaffner W, Gershman K, Harrison LH, Lynfield R, Mohle-Boetani J, Zansky S, Albanese BA, Stefonek K, Zell ER, Jackson D, Thompson T, Schrag SJ. Increasing burden of invasive group B streptococcal disease in nonpregnant adults, 1990–2007. Clin Infect Dis. 2009;49:85–92.
Colford JM Jr, Mohle-Boetani J, Vosti KL. Group B Streptococcal bacteremia in adults five years’ experience and a review of the literature. Medicine. 1995;74:176–90.
Chaiwarith R, Jullaket W, Bunchoo M, Nuntachit N, Sirisanthana T, Supparatpinyo K. Streptococcus agalactiae in adults at Chiang Mai University hospital: a retrospective study. BMC Infect Dis. 2011;11:149.
Lancefield RC, Hare R. The serological differentiation of pathogenic and nonpathogenic strains of hemolytic streptococci from parturient women. J Ex Med. 1935;61:335–49.
Fry RM. Fatal infections by haemolytic streptococcus group B. Lancet. 1938;1:199–201.
Schrag SJ, Verani JR. Intrapartum antibiotic prophylaxis for the prevention of perinatal group B streptococcal disease: experience in the United States and implications for a potential group B streptococcal vaccine. Vaccine. 2013;31:D20–6.
Edwards MS, Rench MA, Palazzi DL, Baker CJ. Group B streptococcal colonization and serotype-specific immunity in healthy elderly persons. Clin Infect Dis. 2005;40:352–7.
Jackson LA, Hilsdon R, Farley MM, Harrison LH, Reingold AL, Plikaytis BD, Wenger JD. Risk factors for group B streptococcal disease in adults. Ann Intern Med. 1995;123:415–20.
Baumgardner DJ. Perinephric abscess caused by group B streptococcus. Am Fam Physician. 2004;69(2764):2766.
Santoro-Lopes G, Halpern M, Gonçalves RT. Perinephric abscess caused by Streptococcus agalactiae after renal transplantation. J Infect. 2005;51:e145–7.
Lopardo HA, Vidal P, Jeric P, Centron D, Paganini H, Facklam RR, Elliott J. Six-month multicenter study on invasive infections due to group B streptococci in Argentina. J Clin Microbiol. 2003;41:4688–94.
Ulett KB, Shuemaker JH, Benjamin WH Jr, Tan CK, Ulett GC. Group B streptococcus cystitis presenting in a diabetic patient with a massive abdominopelvic abscess: a case report. J Med Case Rep. 2012;6:237.
Procopiou M, Genné D, Abbet P, Defabiani N, Rohner S, Auckenthaler R. Acute prostatitis with prostatic abscess caused by group B Streptococcus. Clin Infect Dis. 1998;27:403–4.
Inoue R, Hisasue S, Kunishima Y, Masumori N, Itoh N, Tsukamoto T. Pheochromocytoma with abscess. Int J Urol. 2007;14:644–6.
Genta PR, Dias ML, Janiszewski TA, Carvalho JP, Arai MH, Meireles LP. Streptococcus agalactiae endocarditis and giant pyomyoma simulating ovarian cancer. South Med J. 2001;94:508–11.
Kimura K, Wachino J, Kurokawa H, Matsui M, Suzuki S, Yamane K, Nagano N, Shibayama K, Arakawa Y. High cephalosporin resistance due to amino acid substitutions in PBP1A and PBP2X in a clinical isolate of group B Streptococcus. J Antimicrob Chemother. 2013;68:1533–6.
Harrison LH, Ali A, Dwyer DM, Libonati JP, Reeves MW, Elliott JA, Billmann L, Lashkerwala T, Johnson JA. Relapsing invasive group B streptococcal infection in adults. Ann Intern Med. 1995;123:421–7.
Baker CJ, Rench MA, Paoletti LC, Edwards MS. Dose–response to type V group B streptococcal polysaccharide–tetanus toxoid conjugate vaccine in healthy adults. Vaccine. 2007;25:55–63.
Conflict of interest
The author has no conflicts of interest. This work is authentic and has not been published or submitted elsewhere.
Author information
Authors and Affiliations
Corresponding author
Additional information
The content and views expressed in this publication is the sole responsibility of the author and does not necessarily reflect the views or policies of the hospital.
Rights and permissions
About this article
Cite this article
Crum-Cianflone, N.F. An unusual case of a large, sporadic intra-abdominal abscess due to group B Streptococcus and a review of the literature. Infection 43, 223–227 (2015). https://doi.org/10.1007/s15010-014-0686-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15010-014-0686-1