Two Rare Cases of Neonatal Meningitis Caused by Globicatella sanguinis at the Marrakech University Hospital: Diagnosis and Therapeutic Implications

Two infants, aged 3 and 5 months, were admitted to the neurosurgery ward with febrile meningeal signs and underwent lumbar punctures, which revealed turbid cerebrospinal fluid (CSF) with a predominantly neutrophilic pleocytosis, decreased CSF glucose levels, and elevated CSF protein levels. CSF cultures revealed alpha-hemolytic colonies. Identification by time-of-flight mass spectrometry with matrix-assisted laser desorption and ionization (MALDI-TOF) confirmed Globicatella sanguinis (G. sanguinis) in both cases. G. sanguinis is a pathogenic bacterium that is rarely isolated in clinical practice and can be misidentified as alpha-hemolytic streptococci by conventional laboratory methods. Central nervous system infections caused by G. sanguinis in infants are uncommon but potentially life-threatening. Blood cultures remained negative. Antimicrobial susceptibility testing was performed by microdilution to determine MICs according to the European Committee on Antimicrobial Susceptibility Testing and the Susceptibility Testing Committee of the French Society of Microbiology (CASFM-EUCAST) guidelines for viridans group streptococci/Streptococcus pneumoniae. In the absence of standardized guidelines specific to G. sanguinis, interpretation was based on these criteria. The isolate showed decreased susceptibility to beta-lactams and retained susceptibility to glycopeptides. Both infants received beta-lactam antibiotics. One had a favorable clinical outcome, whereas the other had a fatal outcome. These findings highlight the value of advanced identification methods (MALDI-TOF) in preventing misidentification and optimizing antibiotic therapy.