ステロイド療法中の10 歳女児に発症した B 群レンサ球菌による菌血症の1 例

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  • Group B Streptococcal Bacteremia in a 10-Year-Old Girl Undergoing Corticosteroid Therapy
  • 症例 ステロイド療法中の10歳女児に発症したB群レンサ球菌による菌血症の1例
  • ショウレイ ステロイド リョウホウ チュウ ノ 10サイ ジョジ ニ ハッショウ シタ Bグン レンサ キュウキン ニ ヨル キンケツショウ ノ 1レイ

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Group B streptococcus (GBS), a major cause of neonate and pediatric sepsis and meningitis, rarely causes invasive infection beyond infancy. We report the case of a 10-year-old girl developing GBS bacteremia during corticosteroid therapy for chronic idiopathic thrombocytopenic purpura. Brought to the emergency room due to sudden high fever and abdominal pain, she was in compensated shock. White blood cell count was 19,600/mm3 and C-reactive protein 0.18mg/dL. She was diagnosed with sepsis and admitted for evaluation. Cefotaxime (100mg/kg/day) administration and fluid replacement were begun immediately after blood culture. Her condition improved over the next 6 hours and she was afebrile by the next day. GBS isolated from blood had a serotype of Ib. Based on routine susceptibility testing, this strain was susceptible to penicillin, cephem, carbapenem, erythromycin, clindamycin, and vancomycin, but resistant to quinolone, including levofloxacin (MIC≧8.0μg/mL) and gatifloxacin (MIC≧4.0μg/mL). She was discharged on hospital day 8. This is, to our knowledge, the first report of pediatric meningitis-free GBS bacteremia in Japan. Physicians should therefore be aware of the possibility of invasive GBS infection such as bacteremia in this age group, especially during immunosuppressive therapy, because epidemiological studies in the US have showed significant mortality in those aged 1 to 14 years old with invasive GBS.

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  • 感染症学雑誌

    感染症学雑誌 84 (4), 460-463, 2010

    一般社団法人 日本感染症学会

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