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Granulicatella Infection of the Central Nervous System in a 3-Year-Old Girl.

Granulicatella spp., previously known as nutritionally variant Streptococcus spp., belong to the normal flora of the oral cavity, genitourinary tract, and intestinal tract. Granulicatella spp. have been reported to cause endocarditis, pancreatic abscess, wound infection, vertebral osteomyelitis, conjunctivitis, cirrhosis, endophthalmitis, keratopathy, and otitis media, but the true incidence rates are unknown.1 The literature on management of central nervous system (CNS) infection with Granulicatella spp. is limited. The infectious diseases team at the Children’s Hospital of Eastern Ontario (CHEO) encountered a 3-year-old child with Granulicatella adiacens and elevated total nucleated cells in the cerebrospinal fluid (CSF) following suboccipital craniotomy. This report describes the challenge of antimicrobial management in this case.