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[Meningitis and white matter lesions due to Streptococcus mitis in a previously healthy child]

Reyhan Yiş1, Ciğdem Nükhet Yüksel, Umit Derundere

  • 1Gaziantep Children's Hospital, Gaziantep, Turkey. reyhanyis@yahoo.com

Mikrobiyoloji Bulteni
|November 18, 2011
PubMed

Insights

Streptococcus mitis, a common bacterium, rarely causes severe infections like meningitis and white matter lesions in healthy children. This case highlights a link between sinusitis and S. mitis meningoencephalitis, emphasizing prompt diagnosis and treatment.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Streptococcus mitis is a commensal bacterium of the oropharynx, typically of low pathogenicity.
  • While S. mitis can cause serious infections in immunocompromised individuals, it rarely affects healthy hosts.

Observation:

  • A previously healthy eight-year-old girl developed fever, altered consciousness, and headache.
  • Cerebrospinal fluid analysis revealed meningitis with elevated white blood cells and protein.
  • Brain MRI showed widespread white matter lesions, and CSF culture identified S. mitis.

Findings:

  • The S. mitis infection was linked to a preceding acute sinusitis.
  • The patient responded well to ceftriaxone treatment, with complete recovery.
  • Diagnostic methods included VITEK2 and API 20 STREP for bacterial identification.

Implications:

  • This case underscores that S. mitis can cause severe neurological complications, including meningoencephalitis and white matter lesions, in previously healthy children.
  • Concomitant sinusitis may be a predisposing factor for S. mitis meningitis in pediatric populations.
  • Early recognition and appropriate antibiotic therapy are crucial for favorable outcomes.

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