Late-Onset Neonatal Group B Streptococcus Bacteremia Presenting with Acute Parotitis

Acute bacterial parotitis is a rare disease in children, especially in children < 3 months of age. Typically it is characterized by parotid gland swelling and pus drainage from Stenson’s duct. The most common pathogen is Staphylococcus aureus, but other microorganisms can be implicated; some less frequent agents are other gram-positive cocci, including group B Streptococcus. We present an isolated case of late-onset Group B Streptococcus bacteremia presenting with acute parotitis in a 50-day-old baby boy. The baby was brought to our hospital with a few hour history of irritability, poor sucking and one febrile temperature spike of 39° C, later the baby developed hyperemia with sharp margins and swelling over the left preauricular and submandibular region and jaw line, and drainage of pus into the oral cavity was observed. The laboratory results were nonspecific, but suggested acute bacterial infection; the ultrasonography of the left parotid and preauricular region showed changes, which were consistent with acute parotitis. Later Group B Streptococcus agalactiae was detected in the blood culture. The patient’s status improved after he was started on antibiotics, and he was discharged completely well on the 9th day of hospitalization.