Late-onset neonatal sepsis caused by group A Streptococcus - an unlikely agent
Neonatal sepsis due to group A Streptococcus is rare and has a high associated mortality. The case of a 14-day-old female neonate who presented to the Emergency Department with feed refusal and hyporeactivity is reported. The girl was born at 36 weeks of gestation and had an unremarkable pregnancy and birth. Peripheral white blood cell count was 18.100/mm3 with 81% neutrophils, and C-reactive protein was 13.6 mg/dL. Urinalysis, cerebrospinal fluid cytochemical examination, and chest X-ray were normal. A multisensitive group A Streptococcus was isolated in the blood culture and ten-day course of ampicillin was completed. Urine and cerebrospinal fluid cultures were negative. All co-inhabitants were tested for the presence of group A Streptococcus antigen in the oropharynx, which was positive in a two-year-old cousin.
Group A Streptococcus is an uncommon neonatal sepsis agent. Transmission in the community through a carrier should be considered. This case highlights the importance of infection preventive measures for the newborn at home.
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