Streptococcus equi subspecies zooepidemicus Meningitis, Septicemia, and Brain Infarcts in a Costa Rican Infant.

Streptococcus equi, an equine commensal bacterium, is a rare etiology of septicemia and meningoencephalitis in humans and is extremely infrequent in children. Scarce literature has been published about its clinical presentation, treatment and outcomes in infants. Here, we describe a case of S. equi subsp. zooepidemicus septicemia and meningoencephalitis in a five-month-old Costa Rican infant that was confirmed by peripheral blood and cerebrospinal fluid (CSF) cultures in a regional hospital of the Pacific coast of Costa Rica who developed multiple ischemic cerebral infarcts secondary to infectious vasculitis, a subdural empyema and serious neurological sequelae. We also reviewed the literature on S. equi meningitis in infants under one year of age. This is the first reported case in our country, the fourth reported in infants under one year of age and the second describing multiple cerebral infarcts and subdural empyema in an infant.

Culture-Proven Disseminated and Meningeal Histoplasmosis Presenting as Septic Shock and Autoimmune Hemolytic Anemia in an Infant.

Disseminated histoplasmosis is the most common clinical presentation of histoplasmosis in human immunodeficiency virus (HIV) negative infants from Costa Rica and Latin America. Initial presentation as septic shock and autoimmune hemolytic anemia is uncommon. Even more, detection of Histoplasma capsulatum by culture in peripheral blood and cerebrospinal fluid (CSF) is extremely rare. We describe the case of a three-month-old Costa Rican immunocompetent infant who presented with shock and hemolytic anemia secondary to disseminated histoplasmosis that was confirmed by bone marrow aspirate and positive peripheral blood and CSF cultures.