Hosoda Ai, Gatayama Ryohei, Moriyama Shiori, Ishii Noriyuki, Yamada Kenichiro, Matsuzaki Youhei, Shinjoh Masayoshi
Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan; Department of Pediatrics, Sano Kousei General Hospital, Tochigi, Japan.
Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan.
IDCases. 2016 Nov 24;7:16-18. doi: 10.1016/j.idcr.2016.11.007. eCollection 2017.
Group B streptococcus (GBS) is a commonly recognized cause of sepsis and meningitis in neonatal and young infants. Invasive GBS infection is classified into early onset GBS disease (EOD, day 0-6), late onset GBS disease (LOD, day 7-89) and ultra late onset GBS disease (ULOD, after 3 months of age). ULOD is uncommon and recurrence is especially rare. We present the first recurrent case of ULOD GBS sepsis in 3-year-old girl with a past medical history of hydrops fetalis and thoracic congenital lymphatic dysplasia. The first episode presented as sepsis at 2 years 8 months of age. The second episode occurred as sepsis with encephalopathy at 3 years 1 months of age. During each episode, the patient was treated using intravenous antimicrobials and her condition improved. Serotype examination was not performed in the first episode, but GBS type V was serotyped in the second episode. ULOD over 1 year of age is quite rare and may recur.
B族链球菌（GBS）是新生儿和幼儿败血症及脑膜炎的常见病因。侵袭性GBS感染分为早发型GBS疾病（EOD，第0 - 6天）、晚发型GBS疾病（LOD，第7 - 89天）和极晚发型GBS疾病（ULOD，3个月龄后）。ULOD并不常见，复发尤其罕见。我们报告了首例3岁女童复发性ULOD GBS败血症病例，该女童既往有胎儿水肿和胸段先天性淋巴管发育不良病史。首次发作表现为2岁8个月时的败血症。第二次发作发生在3岁1个月时，表现为败血症合并脑病。每次发作时，患者均接受静脉抗菌药物治疗，病情好转。首次发作时未进行血清型检测，但第二次发作时检测出GBS V型。1岁以上的ULOD非常罕见，且可能复发。
