Fatal maternal beta-hemolytic group B streptococcal meningitis: A case report

Meningitis secondary to beta-hemolytic group B streptococcus is rare and re presents less than 1% of cases of adult meningitis. We report the first kno wn case of maternal mortality attributed to beta-hemolytic group B streptoc occal meningitis. A 23-year-old African-American woman with a benign prenat al course delivered a viable male infant at term. Labor was complicated by thick meconium for which a saline amnioinfusion was utilized. On postpartum Day 1, the patient complained of right hip pain and a headache. Within 12 hr the patient was comatose with fixed and dilated pupils. Life support mea sures were discontinued secondary to absence of electrocortical activity. P ostmortem examination revealed endomyometritis and fulminant meningitis wit h gram-positive cocci. Placental histologic sections demonstrated acute cho rioamnionitis and bateriological cultures noted beta-hemolytic group B stre ptococcus. The virulence of beta-hemolytic group B streptococcus in the neo nate is well recognized. This case demonstrates that beta-hemolytic group B streptococcus is also a potentially fatal maternal pathogen.