Snapshot A 29-year-old woman at 36-weeks gestation presents to her obstetrician for a prenatal visit. She denies any bloody vaginal fluid production and endorses the presence of spontaneous fetal movement. Ultrasonography demonstrates infant size that is appropriate for gestational age. She undergoes a rectal and vaginal swab, which grows group B streptococci. Preparations are made to receive intrapartum penicillin G prophylaxis. Introduction Classification gram-positive cocci that are β-hemolytic produces CAMP factor login to view 1 more bullet catalase-negative facultative anaerobe bacitracin resistant hippurate test positive PYR negative Reservoir vagina and gastrointestinal tract Prevention at 35-37 weeks gestation, a rectal and vaginal swab is performed to determine the presence of group B streptococcus (GBS) if the cultures return positive for GBS, patients receive intrapartum penicillin G or ampicillin prophylaxis Pathogenesis infection occurs in utero secondary to intraamniotic infection rupture of membranes passage through the vagina Associated conditions neonatal meningitis neonatal sepsis neonatal pneumonia Presentation Symptoms/physical exam neonatal septicemia irritability lethargy respiratory distress (e.g., tachypnea, hypoxia, and grunting) neonatal meningitis irritability lethargy respiratory distress (e.g., tachypnea, hypoxia, and grunting) poor feeding and vomiting bulging fontanel nuchal rigidity neonatal pneumonia respiratory distress (e.g., tachypnea, hypoxia, and grunting) login to view 1 more bullet Studies GBS isolation from a sterile body site (e.g., blood and cerebrospinal fluid) Differential Neonatal meningitis by other organisms (e.g., E. coli and L. monocytogenes) differentiating factors E. coli login to view 1 more bullet L. monocytogenes login to view 1 more bullet Treatment Medical penicillin G indication login to view 1 more bullet