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

Abstract

Streptococcus pyogenes meningitis (SPM) occurs sporadically, even with the increase of invasive streptococcal disease observed in the past years. We reported two cases of SPM in infants to alert pediatricians for the possibility of this agent as a cause of meningitis in previously healthy children.

Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis

“…Cefotaxime was reported to fail to prevent and treat S. pyogenes meningitis in one case despite the in vitro susceptibility of the isolate (154). No resistance of group A streptococci to ␤-lactam antibiotics has been reported, and therefore, penicillin remains the first-choice antibiotic (14,175,318). Cephalosporin therapy should be used either cautiously or not at all in view of the reported treatment failure (154).…”

A case of meningitis caused by Streptococcus pyogenes in a previously healthy woman

“…Third-generation cephalosporin, especially ceftriaxone, were suitable alternative agents [8]. Our case was initially treated with ceftriaxone, which constitutes the recommended empirical treatment of meningitis cases in our environment.…”

Aseptic meningitis caused by Leptospira spp diagnosed by polymerase chain reaction

“…Studies report mortality rates of 26% (Mathew et al 2006). The rapid detection of suspected meningitis is critical for determining an appropriate treatment, but confirming the diagnosis of leptospiral meningitis is often difficult, particularly in developing countries, where there are numerous causes of meningitis (Schlech 1992, Mourvillier & Wolff 2006, Arnoni et al 2007, Lammie et al 2009, Khatami & Pollard 2010, Kim 2010, Lin & Safdieh 2010, Marí et al 2010). An initial presumptive diagnosis is normally made on the basis of clinical observations and then culture of leptospires and MAT are used to confirm the diagnosis (Faine et al 1999).…”