Group B streptococcal cellulitis-adenitis in infants
C. J. Baker
Seven infants with group B streptococcal (GBS) cellulitis-adenitis were
compared with nine previously described patients. The clinical features of
infection included a mean age at onset of five weeks, a male predominance
(75%), a history of poor feeding or irritability (94%), and a rapid
resolution with appropriate antimicrobial therapy. Bacteremia occurred in
94% of the patients. Type III GBS were associated with 75% of these
infections; no antibody response to the capsular antigen of these organisms
was detected in convalescent sera. Two of our cases had previously
unreported sites of involvement, inguinal lymph nodes and a thyroglossal
duct cyst. Four infants (80%) with typical facial or submandibular GBS
cellulitis had ipsilateral otitis media at the time of admission. Otitis
media with subsequent lymphatic spread to facial or submandibular areas,
rather than primary bacteremia, may explain the pathogenesis of these
unusual infections.
