Group A streptococcus acute otitis media progressing to neuroinvasive disease in adults

Area of Science:

• Infectious Diseases
• Neurology
• Otolaryngology

Background:

• Acute otitis media (AOM) is a common infection, predominantly affecting children.
• Group A Streptococcus (GAS) is a significant pathogen but a rare cause of AOM and neuroinvasive disease in adults.
• Neuroinvasive disease secondary to AOM in older adults is exceptionally uncommon.

Purpose of the Study:

• To report two rare cases of GAS-induced AOM with neuroinvasive complications in older adults.
• To review the clinical presentation, neuroimaging findings, and management of these unusual cases.
• To explore potential mechanisms of intracranial spread in the context of AOM.

Main Methods:

• Case series review of two patients diagnosed with GAS-related AOM and neuroinvasive disease.
• Analysis of clinical data, including patient history, symptoms, and physical examination findings.
• Review of neuroimaging studies (e.g., MRI, CT scans) and microbiological data.

Main Results:

• Two older adult patients presented with AOM and subsequent neuroinvasive disease caused by Group A Streptococcus.
• Clinical manifestations included [specific symptoms if available, otherwise generalize].
• Neuroimaging revealed [specific findings if available, otherwise generalize], suggesting intracranial spread possibly via tegmen dehiscence.

Conclusions:

• Group A Streptococcus can cause severe AOM with neuroinvasive complications even in older adults.
• Early recognition and appropriate management are crucial for favorable outcomes.
• Bony tegmen dehiscence may represent a pathway for pathogen translocation from the middle ear to the intracranial space.