Rare Presentation of Early Neonatal Pneumococcal Infection: About Two Cases

Background: Streptococcus pneumoniae is a rare cause (1–8%) of maternal-fetal infection but can lead to significant morbidity and mortality in both the newborn and the mother. Objective: This report examined two cases of maternal-fetal infection due to S. pneumoniae. Case Reports: We describe two cases of early-onset neonatal infection caused by S. pneumoniae. Both newborns were full-term and delivered vaginally. They presented with severe clinical symptoms of progressive onset. One case involved a hyperemic pneumonia, while the other developed septic shock associated with meningitis. In both cases, S. pneumoniae was isolated from blood cultures. Soluble pneumococcal antigens were detected in the cerebrospinal fluid in one case. Initial treatment consisted of empirical intravenous dual antibiotic therapy with third-generation cephalosporins (C3G) combined with an aminoglycoside. Vancomycin was added in the second case. Outcomes were poor: one newborn died, and the other developed significant neurological sequelae, including post-meningitic hydrocephalus. Conclusion: Early-onset neonatal infections due to S. pneumoniae are rare but severe, with high morbidity and mortality. Prevention, particularly through vaccination and close perinatal monitoring, remains a key strategy.