title: Late-onset group B streptococcal infection in identical twins: insight to disease pathogenesis.
abstract: Late-onset group B streptococcal (GBS) infection affecting identical twins is described. Although exhibiting similar signs and symptoms at presentation, twin A suffered fulminant fatal meningitis while twin B recovered completely. The GBS isolates proved to be genetically identical and possessed equivalent abilities to invade and injure cells of the human blood-brain barrier in vitro. Clinical variables associated with the adverse outcome in twin A were longer duration of fever prior to antibiotics and the development of neutropenia. The case histories and experimental data are reviewed to underscore key features of GBS disease pathogenesis.
authors.affiliation: Division of Pediatric Infectious Diseases, University of California, San Diego, La Jolla, CA 92093, USA.
authors.forename: Kelly S
authors.initials: KS
authors.lastname: Doran
authors.forename: Vivian M
authors.initials: VM
authors.lastname: Benoit
authors.forename: Robert E
authors.initials: RE
authors.lastname: Gertz
authors.forename: Bernard
authors.initials: B
authors.lastname: Beall
authors.forename: Victor
authors.initials: V
authors.lastname: Nizet
mesh_terms: D017668:Age of Onset; D004200:Diseases in Twins / Q000453:epidemiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D016920:Meningitis, Bacterial / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D013290:Streptococcal Infections / Q000150:complications / Q000453:epidemiology; D013292:Streptococcus agalactiae / Q000235:genetics / Q000472:pathogenicity; D014430:Twins, Monozygotic