Faculty Collaboration Database

Spectrum of Central Nervous System Disease Caused by Streptococcus anginosus Group: A Single-Center Case Series. Pediatr Neurol 2025 Aug;169:161-166

Date

06/25/2025

Pubmed ID

40555144

DOI

10.1016/j.pediatrneurol.2025.05.022

Scopus ID

2-s2.0-105008555769 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

BACKGROUND: To characterize the electrophysiologic and neurological outcomes of pediatric patients with central nervous system infections secondary to Streptococcus anginosus group (SAG).

METHODS: We report a retrospective case series of 15 pediatric patients admitted to the pediatric intensive care unit (PICU) with central nervous system infections caused by SAG.

RESULTS: The population was healthy with no significant comorbidities before presentation. Prodromal symptoms had an acute onset (less than four weeks), with most patients experiencing fever (93%), headache (87%), and fatigue (87%). Fourteen patients (93%) had subdural or epidural empyema, while one (7%) had ventriculitis. Nine patients (60%) underwent continuous electroencephalography recording. Seven patients (47%) had seizures, with three patients (20%) having subclinical seizures only. One patient (7%) developed epilepsy. Five patients (33%) had mild to moderate residual deficits on neurological examination at discharge. Neuropsychologic testing revealed emotional dysregulation (e.g., emotional reactivity, anxiety, depression), attention deficits, and difficulty with working memory.

CONCLUSIONS: Among our cohort, patients were previously healthy with acute onset of nonspecific symptoms. Hospitalization was typically complicated by intracranial abscesses and seizures; the prognosis was favorable, with only one third of patients experiencing neurological deficits at discharge. Neuropsychologic data showed notable psychological deficits following PICU admission.

Author List

Meylor J, Farias-Moeller R, Mehta N, Sawdy R, Patel ND

Authors

Raquel Farias-Moeller MD Associate Professor in the Neurology department at Medical College of Wisconsin
Niyati Mehta MD Associate Professor in the Neurology department at Medical College of Wisconsin
Namrata D. Patel MD Assistant Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Central Nervous System Infections
Child
Child, Preschool
Electroencephalography
Female
Humans
Infant
Intensive Care Units, Pediatric
Male
Retrospective Studies
Streptococcal Infections
Streptococcus anginosus