Group B streptococcal infection differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

Overview

Group B Streptococcus (GBS) infection causes a wide variety of clinical presentations depending on the type of the affected subjects; therefore, the differential diagnosis of GBS infection varies based on the age of the patient and their health condition. Early-onset GBS infection in neonates might lead to pneumonia, meningitis, or sepsis and it must be differentiated from other types of infectious agents in this category of patients.

Differential Diagnosis

Sepsis and Pneumonia in Neonates

The differential diagnosis for early-onset GBS neonatal pneumonia or sepsis includes infection with any of the following:

• Escherichia coli (E.coli)
• Klebsiella
• Staphylococcus aureus
• Streptococcus pneumoniae
• Haemophilus influenza
• Herpes virus
• Candida
• Listeria (less commonly)
• Mycobacterium tuberculosis (less commonly)

The differential diagnosis for late-onset GBS neonatal pneumonia or sepsis includes infection with any of the following:

• Staphylococcus aureus
• Streptococcus pneumoniae
• Streptococcus pyogenes
• Viruses (adenovirus, enteroviruses, influenza, parainfluenza, rhinovirus, and respiratory syncytial virus)
• Candida (less commonly)
• Chlamydia trachomatis

Meningitis in Infants

Shown below is a table summarizing the different pathogens that can cause meningitis in infants.

Age	Possible pathogens causing the bacterial meningitis
< 1 month	Streptococcus agalactiae Escherichia coli Listeria monocytogenes Klebsiella
1-23 months	Streptococcus pneumoniae Neisseria meningitidis Streptococcus agalactiae Haemophilus influenzae E. coli

References

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