Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • fever
  • symptoms of meningitis
  • signs of meningitis
  • symptoms of sepsis
  • signs of sepsis
  • symptoms of pneumonia
  • signs of pneumonia
  • symptoms of UTI
  • signs of UTI
  • symptoms of cellulitis
  • signs of cellulitis
  • symptoms of septic arthritis
  • signs of septic arthritis
  • symptoms of conjunctivitis
  • symptoms of sinusitis
  • signs of sinusitis
  • symptoms of otitis media
  • signs of otitis media
  • symptoms of endometritis
  • signs of endometritis
  • signs of chorioamnionitis

Other diagnostic factors

  • nonspecific signs of infection in neonate
  • nonspecific signs of infection in older patients
  • symptoms of intra-abdominal infection
  • signs of intra-abdominal infection
  • midgestation abortion or preterm labor

Risk factors

  • 0 to 7 days of age
  • maternal fever during labor
  • premature rupture of membranes (PROM)
  • previous baby with GBS disease
  • maternal GBS colonization
  • GBS bacteriuria during pregnancy
  • preterm delivery (<37 weeks)
  • low birth weight (<2500 g)
  • deficient maternal-specific IgG at term
  • twin sibling with GBS disease
  • maternal age <20 years
  • chorioamnionitis
  • age >60 years
  • pregnancy
  • diabetes mellitus
  • advanced hepatic disease
  • advanced renal disease
  • presence of central venous catheter
  • urologic disorders
  • break in skin integrity or skin ulcers
  • neurologic disease
  • immunosuppression
  • nursing-home resident
  • black or Hispanic race
  • malignancy
  • primiparity
  • obstetric manipulation
  • presence of urinary catheter
  • HIV infection
  • trauma
  • asthma
  • consumption of placenta capsules

Diagnostic investigations

1st investigations to order

  • CBC
  • BUN
  • serum electrolytes
  • serum glucose
  • coagulation studies
  • LFTs
  • C-reactive protein
  • blood culture
  • CSF Gram stain
  • CSF culture
  • CSF cell count and differential
  • CSF glucose and protein
  • antigen detection in CSF
  • Gram stain and culture of other sterile body fluids
  • chest x-ray
  • joint x-ray
  • CT head
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant in Microbiology and Infectious Diseases

University Hospital of Wales

Cardiff

UK

Disclosures

BH has received educational grants and fees for consultancy from a number of pharmaceutical companies, including BMS, Gilead, Jannsenn, Abbvie, ViiV, and MSD. This is principally in work relating to hepatitis C and HIV. BH has carried out consultancy work on some antibiotics, including fidaxomicin, linezolid, tedizolid, ceftobiprole, and ceftaroline. BH declares he has no competing interests in relation to the work carried out for this topic review, Group B streptococcus.

Consultant in Microbiology and Infectious Diseases

University Hospital of Wales

Cardiff

UK

Disclosures

HH has received funds from Gilead and Biocomposites related to conference registration, travel, accommodation, and speaker fees.

Dr Brendan Healy and Dr Harriet Hughes would like to gratefully acknowledge Dr Susannah Froude, the previous contributor to this monograph. SF declares that she has no competing interests.

Peer reviewers VIEW ALL

Chief and Professor of Medicine

Division of Infectious Diseases and International Health

University of Virginia Health System

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Assistant Professor

Pediatrics

Attending Physician

Pediatric Emergency Medicine

University of Southern Alabama Children's and Women's Hospital

Mobile

AL

Disclosures

JRH declares that he has no competing interests.

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