Neonatal Sepsis by Streptococcus pyogenes

Abstract

We present herein the case of a newborn patient of appropriate gestational age weight ( 3700 grams), born by vaginal delivery, from a mother that had had 2 previous pregnancies (2 normal deliveries). During the immediate puerperium she had fever. The parents consulted at the age of 2 days, stating that they had noticed difficult breathing since his birth, hipoactivity and poor appetite. He was admitted to the hospital and underwent several studies searching for the origin and germ causing the sepsis. He developed respiratory failure and needed mechanical ventilation for several days on different occasions. He had exudative pleural effusion and hypoxic ischemic seizures. Later on, his blood cultures were positive for Streptococcus pyogenes. Streptococcus pyogenes or Streptococcus βhemolytic group A infection, used to be a common entity in the beginning of the past century, it was commonly associated with puerperal infections and newborn infections, but its incidence declined and nowadays, is uncommon during the neonatal period. Its clinical manifestations could vary from chronic omphalitis up to a low grade septicemia or fulminant meningitis. Since its incidence has declined, at the present time; is an unusual infection of the neonatal period. Ampicillin and gentamicin are currently recommended as first-line antimicrobials, ampicillin replacing the previously recommended penicillin.