2019 Volume 68 Issue 3 Pages 577-583
A patient made an emergency visit for chief complaints of fever, low activity, and low lactation. No increase in the cerebrospinal fluid cell count was seen by examination upon hospitalization, but the patient was hospitalized after close inspection for medical treatment purposes because an enhanced inflammation reaction was recognized by a blood test. Streptococcus agalactiae (GBS) was detected after 3 days of hospitalization by blood and cerebrospinal fluid culture, and ultralate-onset Streptococcus B group meningitis was diagnosed. After the start of therapies such as antimicrobial and γ-globulin therapies, the cell count decreased. However, a sudden increase in the cerebrospinal fluid cell count considered to be caused by aseptic meningitis was recognized after 15 days of hospitalization. However, the inflammatory reaction later attenuated and the cell count continued to decrease. The patient was discharged when her general body condition was good after 57 days of hospitalization. This is a case of ultralate-onset Streptococcus B group meningitis that developed in the patient over a period of 90 days. When the cerebrospinal fluid is first examined less than 24 hours after the onset of fever, attention should be paid to the possibility of the increase in the cerebrospinal fluid cell count.
