Ulett et al. Journal of Medical Case Reports 2012, 6:237 http://www.jmedicalcasereports.com/content/6/1/237 trimethoprim-sulfamethoxazole. This illustrates the need for careful consideration of the antibiotics that are used empirically when GBS is cultured from suspected UTI. Conclusions This case defines a new disease etiology associated with acute streptococcal cystitis and it will be of interest for cases of UTI associated with abdominal and/or pelvic pain. Overall, GBS is a relevant cause of secondary ab- scess of various etiologies in adults, particularly those with underlying medical problems. The particular eti- ology of pyogenic abscess guides clinical management and it is important to treat patients with antibiotics ac- tive against GBS when this organism is found to be the cause of a secondary abscess. Consent Written informed consent for publication was obtained from the patient described in this case report. Ethical ap- proval for the conduct of this work was obtained from the Institutional Review Board of University of Alabama Birmingham under approval number X070722011. Abbreviations CT: Computed tomography; GBS: Group B streptococcus; UTI: Urinary tract infection. Competing interests The authors declare that they have no competing interests. Authors’ contribution KBU and JHS analyzed and interpreted the patient data regarding the diagnosis, WHB and CKT performed the microbiological work, and CKT and GCU wrote the manuscript. All authors read and approved the final manuscript. Acknowledgements The authors would like to thank Janice King, Yvette Hale, and Rebecca Widener for their invaluable assistance in this study, and Marion Woods and Graeme Nimmo for their critical review of the manuscript. All authors declare no conflicts of interest. Author details 1Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA. 2Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA. 3School of Medical Sciences, and Griffith Health Institute, Centre for Medicine and Oral Health, Griffith University, Southport 4222, Australia. 4Present affiliation: Department of Medicine, Royal Brisbane and Women’s Hospital, Bowen Bridge Road, Herston, Queensland 4006, Australia. Received: 7 November 2011 Accepted: 31 May 2012 Published: 10 August 2012 References 1. Edwards MS, Baker CJ: Group B streptococcal infections in elderly adults. Clin Infect Dis 2005, 41:839–847. 2. Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB, Hadler JL, Danila R, Cieslak PR, Schuchat A: Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 2000, 342:15–20. 3. 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