Group B Streptococcal Supraglottitis in a 3-Month-Old Infant

Sir .—Group B streptococcal disease in the first two months of life is most commonly manifested as septicemia, pneumonia, and meningitis. Uncommon clinical manifestations have been described and include otitis media, ethmoiditis, cellulitis, conjunctivitis, endocarditis, urinary tract infection, suprarenal abscess, osteomyelitis, and arthritis. 1 Acute infection of the supraglottic structures, including epiglottitis, usually occurs in children over 1 year of age, and the organism is most often Haemophilus influenzae type b. We describe a 3½-month-old infant with supraglottitis and associated group B streptoccocal bacteremia. To our knowledge, group B streptococcal supraglottitis or epiglottitis has not been previously described. Patient Report .—A previously well 3½-month-old female infant presented to the hospital with a five-hour history of fever and increasing stridor. There was no history of cough or coryza. The child was febrile and irritable, but appeared neither cyanotic nor "toxic." Her cry was muffled. Tachypnea (respirations, 45/min), mild inspiratory stridor, and