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Fatal subdural empyema caused by Streptococcus constellatus and Actinomyces viscosus in a child--case report

Asma Bouziri1, Ammar Khaldi, Hanène Smaoui

  • 1Pediatric Intensive Care Unit, Children's Hospital of Tunis, Place Bab Saadoun, Tunis, Tunisia. asma.bouziri@yahoo.fr

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
|April 29, 2011
PubMed

Insights

Group milleri streptococci, typically harmless oral bacteria, can cause severe brain infections like subdural empyema. This case highlights a rare, fatal infection in a healthy child, emphasizing potential risks.

Area of Science:

  • Microbiology
  • Neurology
  • Infectious Diseases

Background:

  • Group milleri streptococci are common oral and upper airway commensals.
  • These bacteria, especially in combination with anaerobes, are infrequently linked to brain abscesses in predisposed individuals.
  • Brain abscesses and related complications carry a high mortality rate.

Observation:

  • A previously healthy 7-year-old girl developed a fatal subdural empyema.
  • The infection was polymicrobial, involving Streptococcus constellatus and Actinomyces viscosus.
  • This case represents an unusual presentation of these bacteria causing severe central nervous system infection.

Findings:

  • Streptococcus constellatus and Actinomyces viscosus were identified as the causative agents of subdural empyema.
  • The patient, despite being previously healthy, succumbed to the infection.
  • This underscores the potential pathogenicity of these commensal bacteria in rare circumstances.

Implications:

  • Highlights the need for vigilance regarding potential severe infections from seemingly commensal oral flora.
  • Suggests that even healthy individuals may be susceptible to severe neurological complications from these pathogens.
  • Emphasizes the importance of prompt diagnosis and aggressive management of central nervous system infections, regardless of the presumed virulence of the causative organisms.

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