Bacterial Meningitis and Toxic Shock Syndrome Due to Streptococcus pyogenes in a School-Aged Child

Authors

Keywords:

Streptococcus pyogenes, bacterial meningitis, sepsis, pediatrics, septic shock

Abstract

Introduction: Meningitis caused by Streptococcus pyogenes is uncommon. Worldwide, cases have been reported with a fatality rate of 17%, which can increase with streptococcal toxic shock syndrome, and there are high rates of neurological sequelae. Most patients have an extrameningeal focus of infection.

Objective: To describe the clinical course of a pediatric patient with bacterial meningitis and toxic shock syndrome due to Streptococcus pyogenes.

Case Report: We report the case of an eight-year-old male patient with a history of mild head trauma, followed by the appearance of painful swelling in the cervical region, fever, and neurological deterioration. He presented with severe neurological deterioration, and cerebrospinal fluid analysis revealed bacterial infection. Blood cultures and cerebrospinal fluid cultures were positive for Streptococcus pyogenes.

Conclusions: Meningitis caused by Streptococcus pyogenes is uncommon, but it can occur sporadically in otherwise healthy children, especially those with medical history or risk factors such as minor head trauma. Therefore, close monitoring and early treatment are important to improve clinical outcomes and prevent long-term neurological sequelae.

Downloads

Download data is not yet available.

References

1. De Almeida Torres RSL, Fedalto LE, de

Almeida Torres RF, Steer AC, Smeesters PR. Meningitis por estreptococos del

grupo A en niños. Pediatr Infect Dis J. 2013 [acceso 16/09/2022];32(2):110-4.

Disponible en: https://pubmed.ncbi.nlm.nih.gov/22926217/

2. Van de Beek D, de Gans J, Spanjaard L,

Sela S, Vermeulen M, Dankert J. Group a meningitis estreptocócica en adultos:

informe de 41 casos y revisión de la literatura. Clin Infect Dis. 2002 [acceso

16/09/2022];34(9):e32-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/11941569/

3. Ballesteros Moya E, Herrera Castillo

L, Escosa García L, Romero González MP, Lázaro Perona F, José Gómez MI.

Meningitis bacteriana por Streptococcus pyogenes: revisión de la literatura.

Pediatría primaria. 2013 [acceso 16/09/2022];15(60):e173-6. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139-76322013000500014

4. Lee J, Blackburn J, Pham-Huy A. Presentación clínica poco frecuente

de un microorganismo común: meningitis por

Streptococcus del grupo A. Paediatr Child Health. 2021 [acceso 19/09/2024];26(3):e129-31.

Disponible en: https://academic.oup.com/pch/article-abstract/26/3/e129/5848043?redirectedFrom=fulltext

5. Liu BM, Mulkey SB, Campos JM, DeBiasi

RL. Diagnóstico de laboratorio de infecciones del sistema nervioso central en

niños debidas a virus neurotrópicos emergentes y reemergentes. Pediatr Res.

2023;95(2):543-50. DOI: http://dx.doi.org/10.1038/s41390-023-02930-6

6. Dou Z-Z, Li W, Hu H-L, Guo X, Hu B, Chen T-M,

et al. Group A Streptococcal

meningitis in children: a short case series and systematic review. Eur J Clin

Microbiol Infect Dis. 2024;43(8):1517-31. DOI: http://dx.doi.org/10.1007/s10096-024-04863-2

7. Abo Y-N, Oliver J, McMinn A, Osowicki J,

Baker C, Clark JE, et al. Increase in

invasive group A streptococcal disease among Australian children coinciding

with northern hemisphere surges. Lancet Reg Health West Pac. 2023;41:100873. DOI:

http://dx.doi.org/10.1016/j.lanwpc.2023.100873

8. Nygaard

U, Hartling UB, Munkstrup C, Nielsen AB, Dungu KHS, Schmidt LS, et al. Invasive group A streptococcal

infections in children and adolescents in Denmark during 2022-23 compared with

2016-17 to 2021-22: a nationwide, multicentre, population-based cohort study.

Lancet Child Adolesc Health. 2023;8(2):112-21. DOI: http://dx.doi.org/10.1016/S2352-4642(23)00295-X

9. Saadi

AT, Garjees NA, Rasool AH. Antibiogram profile of septic meningitis among

children in Duhok, Iraq. Saudi Med J. 2017 [acceso

27/09/2022];38(5):517-20. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28439602/

10. He W, Wu C, Zhong Y, Li J, Wang G, Yu B, et al. Case report: Therapeutic strategy

with delayed debridement for culture-negative invasive group A streptococcal

infections diagnosed by metagenomic next-generation sequencing. Front Public

Health. 2022;10. DOI: http://dx.doi.org/10.3389/fpubh.2022.899077

11. Baraldés MA, Domingo P, Mauri A,

Monmany J, Castellanos M, Pericas R, et

al. Meningitis estreptocócica del grupo A en la era de los antibióticos.

Eur J Clin Microbiol Infect Dis. 1999 [acceso 16/09/2022];18(8):572-8.

Disponible en: https://pubmed.ncbi.nlm.nih.gov/10517194/

12. Dunne EM, Hutton S, Peterson E, Blackstock

AJ, Hahn CG, Turner K, et al.

Increasing incidence of invasive group A Streptococcus disease, Idaho, USA,

2008-2019. Emerg Infect Dis. 2022;28(9):1785-95. DOI: http://dx.doi.org/10.3201/eid2809.212129

13. Lassoued Y, Assad Z, Ouldali N, Caseris M,

Mariani P, Birgy A, et al. Unexpected

increase in invasive Group A streptococcal infections in children after

respiratory viruses outbreak in France: A 15-year time-series analysis. Open

Forum Infect Dis. 2023;10(5):ofad188. DOI: http://dx.doi.org/10.1093/ofid/ofad188

14. Abuhammour

W, Hasan RA, Unuvar E. Group A beta-hemolytic streptococcal bacteremia. Indian J Pediatr. 2004 [acceso 27/09/2022];71(10):915-9. Disponible

en: https://pubmed.ncbi.nlm.nih.gov/15531835/

15. Link-Gelles

R, Toews K-A, Schaffner W, Edwards KM, Wright C, Beall B, et al. Characteristics of intracranial group A streptococcal

infections in US children, 1997-2014. J Pediatric Infect Dis Soc. 2020;9(1):30-5.

DOI: http://dx.doi.org/10.1093/jpids/piy108

16. Van de Beek D,

Cabellos C, Dzupova O, Esposito S, Klein M, Kloek AT, et al. Guía ESCMID: diagnóstico y tratamiento de la meningitis

bacteriana aguda. Clin Microbiol Infect. 2016 [acceso

10/10/2022];22(Supl.3):S37-62. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27062097/

Published

2025-12-01

How to Cite

1.
Gonzalez Hakspiel L, Sanabria-Pinillos V. Bacterial Meningitis and Toxic Shock Syndrome Due to Streptococcus pyogenes in a School-Aged Child. Rev Cubana Pediatría [Internet]. 2025 Dec. 1 [cited 2025 Dec. 1];97. Available from: https://revpediatria.sld.cu/index.php/ped/article/view/7544

Issue

Section

PEDIATRÍA INTENSIVA