ResumoAtualmente, a meningite bacteriana constitui sério problema de saúde pública mundial. Sua incidência, aliada ao seu potencial de letalidade e seqüelas, torna a doença de extrema importância social, despertando o interesse dos profissionais de saúde quanto ao seu diagnóstico e tratamento precoces.Meningites causadas por Streptococcus pyogenes têm sido consideradas raras na literatura, sendo os sorotipos M1, M3 e M18 associados a maior virulência e elevado potencial de letalidade. O presente estudo tem como objetivo descrever um caso de paciente masculino de 14 anos de idade, com otite média aguda, que evoluiu com meningite por Streptococcus pyogenes, septicemia e óbito. As cepas de S. pyogenes isoladas de cultura de líquor e hemocultura foram submetidas à tipagem molecular pelos métodos Pulse-field gel electrophoresis (PFGE) e emm, identificando-se o sorotipo M3. Pôde-se concluir que, tratava-se de cepa potencialmente agressiva, freqüentemente associada a quadros fatais, com evolução a partir de otite média aguda supurada, doença bastante freqüente na comunidade. Os profissionais de saúde devem atentar para o aumento de infecções letais provocadas por esta bactéria, sendo altamente desejável o diagnóstico e tratamento precoces.Palavras-Chave: Meningite otogênica; otite média aguda; Streptococcus pyogenes; sepse. AbstractBacterial meningitis is a serious current public health problem worldwide. Its incidence and potential capacity to cause lethality and sequels turn the disease into a very important social problem, taking interest of health professionals to early diagnosis and treatment. Meningitis caused by Streptococcus pyogenes has been considered rare in the literature, and the serotypes M1, M3 and M18 are associated to high virulence, frequently causing death. The present study aims to report a case of a 14 year-old male patient with acute otitis media, followed with meningitis by Streptococcus pyogenes, sepsis and death. The strains of S. pyogenes isolated from cerebrospinal fluid culture and hemoculture were submitted to molecular typing using Pulse-field gel electrophoresis (PFGE) and emm methods, identifying serotype M3. We concluded that this strain is potentially aggressive, frequently associated with lethal infections, beginning with suppurate acute otitis media, a common infection in community. The health professionals should pay attention at the increase of lethal infections caused by this pathogen, being important the early diagnosis and treatment.
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