GROUP-B STREPTOCOCCAL MENINGITIS IN ADULTS - REPORT OF 12 CASES AND REVIEW

Group B streptococcus (GBS) is the leading etiologic agent of bacteria l meningitis and sepsis during the neonatal period, but it is an infre quent cause of meningitis in adults. We report 12 episodes of group B streptococcal meningitis in adults and review 52 cases reported in the literature. A total of 24 men and 40 women were included in the study ; the mean age (+/- SD) was 49.2 +/- 20.5 years (range, 17-89 years). All the patients had cerebrospinal fluid cultures positive for GBS. Ei ghty-six percent of the patients had comorbid conditions, 50% had a di stant focus of infection, and blood cultures yielded GBS for 78.7%. Th e overall case-fatality rate was 34.4% (22 patients). Factors associat ed with a poor outcome were advanced mean age (+/- SD) (61.5 +/- 17.4 years vs. 42.8 +/- 19.2 years; P = .0003) and the presence of complica tions on admission (P = .0001). Seven percent of survivors had neurolo gical sequelae. Group B streptococcal meningitis in adults has become increasingly frequent in recent years; it tends to occur in patients w ith severe underlying conditions and is associated with a high case-fa tality rate. Factors associated with a poor prognosis are advanced age and the occurrence of neurological and extraneurological complication s.