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September 1987

Fever Without Localizing Signs and Group B Streptococcus Bacteremia in Two Patients 90 Days of Age and Older

Author Affiliations

University of Wisconsin Hospital 600 Highland Ave Madison, WI 53792

Am J Dis Child. 1987;141(9):940-941. doi:10.1001/archpedi.1987.04460090017009

Sir.—Group B streptococcus (GBS) is the most common bacterial agent causing bacteremia and/or meningitis in premature infants and in infants younger than 6 weeks of age.1 The following is a description of two patients 90 days of age or older who had unsuspected bacteremia with GBS.

Patient 1.—A 90-day-old female infant presented to the emergency room with a five-hour history of "breathing trouble and feeling hot." Rectal temperature was 40.5°C; heart rate, 212 beats per minute; and respirations, 40/min. Other than a fine, peeling rash on the trunk, arms, and legs, the results of the physical examination were normal. After administration of acetaminophen (15 mg/kg), rectal temperature was 38.5°C; heart rate, 160 beats per minute; and respirations, 40/min. A chest roentgenogram was normal.

A complete blood cell (CBC) count showed the following: white blood cell (WBC) count, 10×109/L(0.67 [67%] polymorphonuclear neutrophils [PMNs], 0.10 [10%]