Intracranial haemorrhage in late-onset neonatal group B streptococcal disease: A case report.

This report aims to alert clinicians to the possibility of intracerebral haemorrhage as a rare manifestation of late-onset neonatal group B streptococcal (LOGBS) disease. This case also highlights the need for effective treatment guidelines for LOGBS disease. We report a case of LOGBS disease in a 17-day-old full-term female neonate, complicated by bilateral subarachnoid haemorrhage confirmed on magnetic resonance imaging (MRI). The patient presented with fever, lethargy, and convulsions. Microbiological examination confirmed the presence of Streptococcus agalactiae in the blood culture. Brain MRI showed bilateral subarachnoid haemorrhage and diffuse cerebral ischaemia, suggesting a severe complication of LOGBS disease. Short-term follow-up of the patient showed marked developmental delay. Early screening for group B streptococcus infection in pregnant women is essential to prevent severe cases of LOGBS disease. Very few cases of intracerebral haemorrhage in LOGBS disease have been reported. Further evidence is required to support a pertinent link between LOGBS disease and intracerebral haemorrhage.

Factors That Influence Mortality in Critically Ill Patients with SARS-CoV-2 Infection: A Multicenter Study in the Kingdom of Saudi Arabia.

BACKGROUND: SARS-CoV-2 infection has a high mortality rate and continues to be a global threat, which warrants the identification of all mortality risk factors in critically ill patients. METHODS: This is a retrospective multicenter cohort study conducted in five hospitals in the Kingdom of Saudi Arabia (KSA). We enrolled patients with confirmed SARS-COV-2 infection admitted to any of the intensive care units from the five hospitals between March 2020 and July 2020, corresponding to the peak of recorded COVID-19 cases in the KSA. RESULTS: In total, 229 critically ill patients with confirmed SARS-CoV-2 infection were included in the study. The presenting symptoms and signs of patients who died during hospitalization were not significantly different from those observed among patients who survived. The baseline comorbidities that were significantly associated with in-hospital mortality were diabetes (62% vs. 48% among patients who died and survived (p = 0.046)), underlying cardiac disease (38% vs. 19% (p = 0.001)), and underlying kidney disease (32% vs. 12% (p < 0.001)). CONCLUSION: In our cohort, the baseline comorbidities that were significantly associated with in-hospital mortality were diabetes, underlying cardiac disease, and underlying kidney disease. Additionally, the factors that independently influenced mortality among critically ill COVID-19 patients were high Activated Partial Thromboplastin Time (aPTT )and international normalization ratio (INR), acidosis, and high ferritin.