# Group B Streptococcal Subscapular Abscess: A Case Report and Review of Literature

## TL;DR

This case report describes an 83-year-old patient with a rare subscapular abscess caused by Group B Streptococcus, emphasizing the importance of early diagnosis and treatment.

## Contribution

The paper reports the first case of Group B Streptococcus as a causative agent for subscapular abscess and provides a literature review of 26 cases.

## Key findings

- Group B Streptococcus was identified as the causative organism in a subscapular abscess, a first-time report.
- A muscle-sparing surgical approach was successfully used for drainage in an elderly patient.
- A review of 26 cases highlights clinical features, risk factors, and treatment approaches for subscapular abscesses.

## Abstract

Subscapular abscesses are rare, and delayed diagnosis is common. Diagnosis is difficult as it often presents with mild symptoms like stiffness and muscular pain, mimicking other more common pathologies. Delayed diagnosis can lead to the spread of infection and increased morbidity and mortality. A high index of suspicion, prompt imaging, and early surgical drainage are keystones of management. Though all age groups are known to be affected, our case is the oldest reported patient at 83 years. He developed an abscess following a hematoma due to manipulation during physiotherapy, which subsequently got infected. Ultrasonogram and MRI demonstrated the abscess in the subscapular space. Culture and microscopy of the aspirate revealed the causative organism to be Streptococcus agalactiae, a Group B Streptococcus (GBS), which has not previously been reported as a causative organism. Invasive GBS (IGBS) in the elderly is a growing concern. We opted to drain the collection using a muscle-sparing, single-incision posterolateral approach. A literature review yielded 26 cases, which were then analyzed for age, sex, risk factors, clinical presentation, imaging, bacteriological profile, antibiotic use, and surgical approaches.