Prognosis

Group B streptococci (GBS) infection can be rapidly fatal. In early-onset infection, even with prompt and appropriate treatment, mortality is 4% to 13%.[21][71] Mortality is higher in lower-weight babies (42% case fatality rate in babies <2500 g versus 7% in babies ≥2500 g).[28]

In late-onset infection, mortality is highest in those who present with meningitis. Overall case fatality is low, at 3%.[17][71]

GBS infection is more likely to be fatal in adults than in children. Mortality depends on the focus of infection, with pneumonia having a mortality of 41%. Overall mortality is 21% to 25%.[21][26]

Infective endocarditis from GBS can affect native and prosthetic valves and is associated with high mortality.[100]

Monitoring

Standard monitoring of patients on treatment should take place. This normally consists of repeat complete blood count, C-reactive protein, and BUN and electrolytes at regular intervals until resolution. Follow-up cultures are not generally recommended but may be appropriate in patients who are not responding to therapy. Likewise, follow-up imaging may be required in certain circumstances.

Morbidity

Of nonpregnant adults who survive a GBS invasive infection, 4% will have a recurrence.[101] GBS arthritis can result in permanent functional impairment of the affected joint. GBS disease in childhood is associated with an increased risk of neurodevelopmental impairment. The risk is particularly high with GBS meningitis.[102][103]

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