Sir.—Group B streptococcus (GBS) is the most common bacterial agent causing bacteremia and/or meningitis in premature infants and in infants younger than 6 weeks of age.1 The following is a description of two patients 90 days of age or older who had unsuspected bacteremia with GBS.
Patient 1.—A 90-day-old female infant presented to the emergency room with a five-hour history of "breathing trouble and feeling hot." Rectal temperature was 40.5°C; heart rate, 212 beats per minute; and respirations, 40/min. Other than a fine, peeling rash on the trunk, arms, and legs, the results of the physical examination were normal. After administration of acetaminophen (15 mg/kg), rectal temperature was 38.5°C; heart rate, 160 beats per minute; and respirations, 40/min. A chest roentgenogram was normal.
A complete blood cell (CBC) count showed the following: white blood cell (WBC) count, 10×109/L(0.67 [67%] polymorphonuclear neutrophils [PMNs], 0.10 [10%]