Complications

Complication
Timeframe
Likelihood
short term
medium

As a consequence of bacterial infection, a systemic inflammatory response may occur. This may manifest as hypotension, tachycardia, and pyrexia.

Managed in an intensive care setting.

short term
medium

A consequence of GBS meningitis that can lead to cerebral oedema and seizures.

Neurosurgical opinion is required.

While awaiting neurosurgical review, the patient should be elevated (head of the bed 30° to 40°). Mannitol may be considered.

short term
low

Can occur in GBS meningitis and should be managed with benzodiazepines or anticonvulsants.

short term
low

Most common neurological complication of GBS meningitis, reported in 7% of survivors.[1]

Up to 50% of patients with meningitis develop a neurological complication, the most common being sensorineural deafness.

Managed by referral to audiology for consideration of hearing aids or cochlear implants.

short term
low

Empyema can occur with GBS pneumonia.

In general, complete drainage is required.

short term
low

Potential complication of sepsis, particularly in patients with valvular heart disease or prosthetic heart valves.

Cardiology and infectious disease consultation is recommended. Prolonged antibiotic treatment is required.

Surgery may be required in selected cases.

short term
low

Potential complication of sepsis or skin and soft-tissue infection.

Orthopaedic and infectious-disease consultation is recommended. Prolonged antibiotic therapy is required.

Surgery may be required in selected cases.

short term
low

Many cases are polymicrobial, and broad-spectrum antibiotic therapy (e.g., meropenem and clindamycin) according to local guidelines should be initiated.

Benzylpenicillin or ampicillin, plus clindamycin is recommended if polymicrobial infection is excluded or extremely unlikely.[103]

Use of additional therapies such as hyperbaric oxygen and intravenous immunoglobulin remains controversial.[104]

Urgent surgical debridement is required. Antibiotic therapy alone is insufficient.

long term
medium

GBS disease in childhood is associated with an increased risk of neurodevelopmental impairment. The risk is particularly high with GBS meningitis.[101][102]

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