Group B beta hemolytic streptococcal sepsis in the newborn.

Group B Beta Hemolytic streptococcal infection among newborn infants has recently grown in importance. The pathological changes in the early onset cases appear to be confined to the lung. In our patients, hyaline membranes with peripheral atelectasis was unusual, although fibrin deposited in areas without accompanying atelectasis may lead to confusion with hyaline membrane disease. The clinical features and pathologic changes caused by GBS had some differences from those due to other organisms giving rise to fatal pneumonia in the newborn. The lungs of GBS-infected babies in our autopsy series were not as heavy, had more alveolar fibrin deposition, but not more hyaline membrane disease than in nonstreptococcal cases. Alveolar inflammation was more marked in nonstreptococcal cases, but the GBS cases had more interstitial inflammation. Massive alveolar bacterial growth was more common in the GBS cases. Chronic thymic involution was less marked in the GBS cases, while acute splenitis was more common. Meningitis was present in four of our nonstreptococcal cases, but in none of the GBS cases. The clinical courses of GBS and nonstreptococcal fatal pneumonias differed. The mothers of infants with GBS infection were less febrile and ahd an increased frequency of prolonged rupture of the membranes, while the infants had a decreased duration of life, compared to those with nonstreptococcal sepsis.