Germano Nicholas, Sibbel Maria Gunnes, Summerfield Douglas, Pitzenberger Abbey
Internal Medicine, Mercy Medical Center North Iowa, Mason City, Iowa, USA.
Acute Care Pharmacy, Mercy Medical Center North Iowa, Mason City, Iowa, USA.
BMJ Case Rep. 2019 Aug 8;12(8):e228040. doi: 10.1136/bcr-2018-228040.
(group B streptococcus or GBS) is the most common cause of bacterial meningitis in infants, but is rarely the cause in adults. Across all non-pregnant adults it comprises 7% of bacterial meningitis cases, with a mortality rate of 56% in the elderly. Therefore, while rare, GBS should be a part of a patient's differential when initiating antibiotics in adults with chronic illnesses. We report a 78-year-old diabetic female admitted to the hospital with suspected meningitis. Lumbar puncture revealed grossly purulent cerebrospinal fluid (CSF) and she was started on antibiotics for empiric treatment of expected Thirty-one hours post-sampling, the CSF culture results returned positive for beta haemolytic GBS and treatment was altered accordingly. The case was complicated by concomitant periodic lateralising epileptiform discharges which were treated simultaneously. After 14 days of hospitalisation, the patient was discharged to a skilled nursing facility for further recovery.
B族链球菌（GBS）是婴儿细菌性脑膜炎最常见的病因，但在成人中很少见。在所有非妊娠成人中，它占细菌性脑膜炎病例的7%，在老年人中的死亡率为56%。因此，虽然罕见，但在对患有慢性病的成人启动抗生素治疗时，GBS应作为患者鉴别诊断的一部分。我们报告了一名78岁的糖尿病女性因疑似脑膜炎入院。腰椎穿刺显示脑脊液（CSF）严重化脓，她开始使用抗生素进行经验性治疗，预期治疗效果。采样后31小时，脑脊液培养结果显示β溶血性GBS呈阳性，治疗相应改变。该病例并发周期性侧化癫痫样放电，同时进行了治疗。住院14天后，患者出院至专业护理机构进一步康复。
