Streptococcus gallolyticus Subspecies (subsp.) pasteurianus Meningitis in a 7-week-old Boy.

Meningitis caused by Streptococcus gallolyticus subspecies (subsp.) pasteurianus is a rare complication with 14 cases reported in literature worldwide between 2003-2023, with the majority of the cases occurring before 4 weeks of life and with preceding symptoms. This is a case report of an infection without any preceding symptoms. A previously healthy 7-week-old boy presented to the hospital with a fever for 1 day. Blood and cerebrospinal fluid cultures ultimately grew Streptococcus gallolyticus subsp. pasteurianus. The magnetic resonance imaging was consistent with meningitis. The boy received 21 days of intravenous antibiotics before discharge. At subsequent visits, the boy had no neurological sequelae, normal hearing tests, and appeared to have met all developmental milestones. The older age of infant should not discount the differential diagnosis for meningitis, which may delay further work up such as a lumbar puncture. Group D streptococcus is an uncommon cause of infantile sepsis that can lead to several complications such as meningitis and bacteremia. In this case, the infant's subsequent post-meningitis clinical course has been unremarkable. The history of meningitis poses increased risk for abnormal neurodevelopmental outcome. This case study highlights the importance of keeping meningitis on the differential diagnosis for an infant with fever. If there is a concern for meningitis, further workup should be performed without delay.

Vaccine-Strain Varicella Virus Transmitted to a Term Infant Following Maternal Postpartum Vaccination.

Varicella is a highly contagious disease caused by Varicella-zoster virus (VZV). The American College of Obstetricians and Gynecologists (ACOG) adopted the routine administration of varicella vaccine to varicella non-immune mothers postpartum before leaving the facility per the Advisory Committee in Immunization Practices (ACIP) recommendation of Varicella prevention. While the vaccine is well-tolerated, a live attenuated vaccine has the potential to cause clinical symptoms and complications, including rash. Secondary transmission of the vaccine virus from healthy persons is rare. Only 13 confirmed cases of secondary transmission from 11 immunocompetent vaccine recipients have been reported. We report the confirmed case of extensive neonatal varicella disease in a neonate after exposure to a vaccine varicella rash that developed after maternal postpartum vaccination.