title: The first case of recurrent ultra late onset group B streptococcal sepsis in a 3-year-old child.
abstract: Group B streptococcus (GBS) is a commonly recognized cause of sepsis and meningitis in neonatal and young infants. Invasive GBS infection is classified into early onset GBS disease (EOD, day 0-6), late onset GBS disease (LOD, day 7-89) and ultra late onset GBS disease (ULOD, after 3 months of age). ULOD is uncommon and recurrence is especially rare. We present the first recurrent case of ULOD GBS sepsis in 3-year-old girl with a past medical history of hydrops fetalis and thoracic congenital lymphatic dysplasia. The first episode presented as sepsis at 2 years 8 months of age. The second episode occurred as sepsis with encephalopathy at 3 years 1 months of age. During each episode, the patient was treated using intravenous antimicrobials and her condition improved. Serotype examination was not performed in the first episode, but GBS type V was serotyped in the second episode. ULOD over 1 year of age is quite rare and may recur.
authors.affiliation: Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan; Department of Pediatrics, Sano Kousei General Hospital, Tochigi, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Hosoda
authors.affiliation: Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Gatayama
authors.affiliation: Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan.
authors.forename: Shiori
authors.initials: S
authors.lastname: Moriyama
authors.affiliation: Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ishii
authors.affiliation: Department of Pediatrics, Hiratsuka City Hospital, Kanagawa, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Youhei
authors.initials: Y
authors.lastname: Matsuzaki
authors.affiliation: Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Shinjoh
keywords: Clinically mild encephalopathy with a reversible splenial lesion; Group B streptococcus; MERS; Recurrence; Sepsis; Ultra late onset disease