Beyond Colonization: An Atypical Presentation of Maternal Group B Streptococcus Infection

Group B Streptococcus (GBS), a commensal species that colonizes the genitourinary and GI tracts of many women, is well-studied as a leading cause of neonatal infection in the United States. Maternal colonization is the primary risk factor for neonatal sepsis, with vertical transmission from mother to fetus occurring during delivery. To reduce this risk, universal screening and intrapartum antibiotic prophylaxis have been implemented. While many women who test positive for colonization are asymptomatic, a small subset may develop invasive GBS infections such as bacteremia, meningitis, or pneumonia. In this report, we describe a rare presentation of invasive maternal GBS in a 32-year-old woman with GBS bacteremia and associated cellulitis. The patient was appropriately treated with antibiotics at the time of presentation and again during delivery. This case highlights the importance of recognizing and reporting atypical manifestations of GBS infection in pregnancy to better characterize the full spectrum of the disease.