Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a common pathogen in the neonatal period, causing
meningitis and
sepsis. In non-pregnant adults it is an unusual cause of
meningitis. We report about an elderly female with several risk factors for invasive GBS
infection who developed GBS
meningoencephalitis one month
after treatment for
COVID-19 upper respiratory tract infection. The patient presented with
mania, and the classic triad of
headache, neck stiffness, and
fever was absent which contributed to the delay in diagnosis. Following initiation of treatment with intravenous
ceftriaxone she attained full recovery, and her behavior returned to baseline. This case illustrates an unusual presentation of an emerging
infection and should alert clinicians about this presentation. By reporting this case we want to raise awareness about
mania as a presenting feature of
meningoencephalitis. This should lead to more timely diagnosis and better outcomes for future patients.