Meningitis in a Girl with Recurrent Otitis Media Caused by Streptococcus pyogenes - Otitis Media Has to Be Treated Appropriately

Steppberger, K.; Adams, IP; Deutscher, J; Müller, Hermann; Kieß, Wieland

doi:10.1007/s15010-001-1065-2

Cited by 17 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Generally, it is not present as a complication of the invasive disease and there is frequently an association with contiguous infectious foci of the upper respiratory tract. Furthermore, some risk factors have been described: neurosurgery, skull fractures, CSF leaks, infection or colonization of the upper respiratory tract and skin lesions (impetigo, varicella and erysipelas) [1,5]. However, SPM also occurs in healthy individuals that do not have predisposing conditions and do not present clear evidences of a contiguous focus [3].…”

Section: Discussionmentioning

confidence: 99%

“…In SPM during infancy, the evolution to neurological complications and sequelae are described in 60% of the cases, with a mortality rate of up to 12% [1,3]. Chow & Muder reported a global lethality of 5% and sequelae in 46% of the cases in a review conducted between 1981 and 1991 [14].…”

Section: Discussionmentioning

confidence: 99%

“…Streptococcus pyogenes is an agent rarely associated to meningitis and corresponds to 0.2-1% of the cases [1,2], usually as a contiguous infection site, such as otitis, sinusitis and mastoiditis [1].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Streptococcus pyogenes meningitis in children: report of two cases and literature review

Arnoni¹,

Berezin²,

Sáfadi³

et al. 2007

Braz J Infect Dis

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Streptococcus pyogenes meningitis in children: report of two cases and literature review

Arnoni¹,

Berezin²,

Sáfadi³

et al. 2007

Braz J Infect Dis

View full text Add to dashboard Cite

show abstract

“…Two recent reviews of the literature 2,3 that addressed confirmed cases of GAS meningitis among children and adults in the past 3 decades found only 2 children with brain abscesses, 2 children with subdural hygromas (1 of whom required surgical drainage and shunt insertion), 13 and none with a subdural empyema. Subsequent cases of pediatric GAS meningitis with a subdural hygroma 14 and an empyema 15 have been reported. However, none of these children experienced varicella before the episode of GAS meningitis.…”

Section: Discussionmentioning

confidence: 99%

Group A Streptococcal Subdural Empyema as a Complication of Varicella

2005

View full text Add to dashboard Cite

ABSTRACT. Group A ␤-hemolytic streptococcus and Staphylococcus aureus are the 2 most common pathogens implicated in secondary invasive bacterial disease after varicella. We describe a 3-month-old male infant from British Columbia, Canada, who presented on day 5 of varicella skin rash with fever, seizures, lethargy, and evidence of intracranial hypertension. A prominent subdural empyema was documented, and Streptococcus pyogenes was recovered from the subdural fluid. Central nervous system bacterial complications should be part of the differential diagnosis for infants and children with chickenpox who present with fever, lethargy, focal seizures, or similar neurologic findings. This case illustrates the importance of universal varicella vaccination to prevent associated bacterial complications of chickenpox. T he clinical course of varicella in childhood is usually benign and self-limited. However, secondary bacterial complications can occur in skin, soft tissues, and other sites, caused predominantly by group A streptococcus (GAS) and Staphylococcus aureus. 1 For varicella-associated, invasive, suppurative complications, the former is associated with increased morbidity and mortality rates among both immunocompetent and immunosuppressed children, and episodes can occur even without an obvious skin source of infection. Among children, GAS infections of the central nervous system (CNS) and peripheral nervous system after chickenpox are extremely rare. [2][3][4] We describe an infant who developed a GAS subdural empyema during varicella, which is, to our knowledge, an association not described previously. CASE REPORTA 3-month-old boy was admitted to a community hospital, on day 5 of a varicella skin rash, with fever and focal seizures. On day 1 of the rash, the patient developed decreased appetite and vomited twice; the following day, he began to exhibit a fever of 39°C. On day 4, he was examined at a primary care clinic, a diagnosis of acute otitis media (AOM) was made, and treatment with orally administered trimethoprim-sulfamethoxazole was initiated (the patient received a total of 2 doses). On day 5, the patient was described by his parents as being irritable and lethargic, and that night he developed right-sided focal seizures of the face, arm and leg, with subsequent ocular deviation. The seizures persisted, became generalized, and led to status epilepticus, which necessitated repeat doses of intravenously administered diazepam and phenytoin after admission to the local hospital. The body temperature was 37.8°C, a diffuse varicella skin rash with no evidence of secondary bacterial infection was described, and no AOM was observed. The patient underwent head computed tomography, which showed bilateral subdural fluid collections with left-sided predominance, with a compressed ventricular system and mild midline deviation. A clinical diagnosis of varicella encephalitis and subdural effusions was made, blood cultures were obtained, 1 dose of acyclovir was administered intravenously, and the patient was transferred...

show abstract

“…De acordo com Steppberger et al 9 , as meningites causadas por S. pyogenes são bastante raras e quando ocorrem, costumam ter um prognóstico ruim, com elevada taxa de óbito ou seqüelas importantes.…”

Section: Introductionunclassified

Meningite otogênica por Streptococcus pyogenes sorotipo M3

Person

Tanaka

Iwamoto

2008

Arq. Bras. Ciên. Saúde

View full text Add to dashboard Cite

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.

show abstract

Meningitis in a Girl with Recurrent Otitis Media Caused by Streptococcus pyogenes - Otitis Media Has to Be Treated Appropriately

Cited by 17 publications

References 12 publications

Streptococcus pyogenes meningitis in children: report of two cases and literature review

Streptococcus pyogenes meningitis in children: report of two cases and literature review

Group A Streptococcal Subdural Empyema as a Complication of Varicella

Meningite otogênica por Streptococcus pyogenes sorotipo M3

Contact Info

Product

Resources

About