Streptococcus group C meningitis with cavernous sinus thrombosis

Abstract

Group C Streptococcus (GCS) is a rare cause of bacteremia in humans. It is mostly associated with zoonological infections. Although GCS can be part of the normal oral, skin, and genitourinary fora, an infection with this pathogen can be highly virulent, causing rapid, disseminating disease. With a mortality of about 25%, the poor prognosis is linked to the severity of illness and the high level of virulence of the organism. Only a few cases of GCS meningitis have been reported. We present the first case of GCS meningitis with cavernous sinus thrombosis.

Pathogenicity of Virulent Species of Group C Streptococci in Human

“…The aforementioned S. anginosus group (called S. milleri by some authors) contains three species: S. anginosus , S. constellatus , and S. intermedius [7, 8, 11, 15]. The species that belong to the S. anginosus group contain in their cellular wall the carbohydrate groups A, C, F, and G or they contain none [11].…”

“…Phenotypes of group C streptococci and group G streptococci (GGS) form a large colony, which makes them different from the phenotypes belonging to the S. anginosus group, which form a small colony, irrespective of the carbohydrate group [ 7 ]. The aforementioned S. anginosus group (called S. milleri by some authors) contains three species: S. anginosus , S. constellatus , and S. intermedius [ 7 , 8 , 11 , 15 ]. The species that belong to the S. anginosus group contain in their cellular wall the carbohydrate groups A, C, F, and G or they contain none [ 11 ].…”

“…Facklam shows that virulent streptococci, including those from group C, manifest a negative reaction in optochin sensitivity and bile solubility tests [ 11 ]. Aside from the aforementioned methods, Clarke et al report that GCS can also be differentiated from other species through their capacity for sorbitol and trehalose fermentation ([ 8 ], Table 1 ). Among the phenotypes belonging to GCS, only S. equi subs.…”

“…They have shown a 100% increase of bacteremia between 2006 and 2012 and an increase of SDSE infections in Asia, Europe, and the USA [ 12 , 14 ]. Of particular interest are the reports about the relations between GCS with the pathogenesis of rheumatic fever in Australia and India [ 5 , 21 , 23 ] and first documented zoonotic diseases [ 6 , 8 , 9 , 22 , 24 ].…”

“…equisimilis (SDSE) [ 10 , 12 ]; it may cause skin infections (cellulitis) and recurrent blood infections [ 13 ]. According to Clarke the GCS species, not mentioned before, most often isolated from the human throat is S. milleri [ 8 ], also known as S. anginosus group [ 11 ].…”