Group B streptococcal cellulitis-adenitis in infants.

Seven infants with group B streptococcal (GBS) cellulitis-adenitis were compared with nine previously described patients. The clinical features of infection included a mean age at onset of five weeks, a male predominance (75%), a history of poor feeding or irritability (94%), and a rapid resolution with appropriate antimicrobial therapy. Bacteremia occurred in 94% of the patients. Type III GBS were associated with 75% of these infections; no antibody response to the capsular antigen of these organisms was detected in convalescent sera. Two of our cases had previously unreported sites of involvement, inguinal lymph nodes and a thyroglossal duct cyst. Four infants (80%) with typical facial or submandibular GBS cellulitis had ipsilateral otitis media at the time of admission. Otitis media with subsequent lymphatic spread to facial or submandibular areas, rather than primary bacteremia, may explain the pathogenesis of these unusual infections.