Invasive Streptococcus agalactiae Disease With Meningitis and Septic Arthritis in a Non-pregnant Patient

Streptococcus agalactiae is a common constituent of the human flora. However, infection in immunocompetent adults is uncommon and the involvement of the central nervous system (CNS) or development of septic arthritis are exceedingly rare and by our knowledge, were only described simultaneously once in a retrospective study. We present the case of a 66-year-old woman with S. agalactiae bacteremia presenting meningitis and septic arthritis of the left shoulder. The patient presented to the emergency department with altered mental status and fever. Lumbar puncture revealed cerebral spine fluid (CSF) pleocytosis and elevated proteins. Blood and CSF cultures identified the presence of a susceptible strain of S. agalactiae. During hospitalization, the patient complained of left shoulder pain, enabling the identification of articular fluid collections, which were drained confirming their infectious origin. Colic ulcers were found to be the starting point of this infection with posterior involvement of the CNS and the development of septic arthritis by hematogenous dissemination.