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Bacterial meningitis due to the Streptococcus mitis group in children with cerebrospinal fluid leak

Haruka Fukayama1,2, Kensuke Shoji3, Michiko Yoshida3

  • 1National Center for Child Health and Development, Department of General Pediatrics and Interdisciplinary Medicine, Tokyo, Japan.

Idcases
|February 11, 2022
PubMed

Insights

This case study highlights a rare instance of Streptococcus mitis meningitis in a pediatric patient with Gorham-Stout disease and a cerebrospinal fluid leak. Prompt antibiotic treatment led to a successful recovery without neurological complications.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Neurology

Background:

  • The Streptococcus mitis group is a common oral bacterium, typically associated with infections like endocarditis and sepsis.
  • Meningitis caused by the Streptococcus mitis group is rare in children, especially in those with underlying skull base abnormalities.

Observation:

  • A 14-year-old girl with Gorham-Stout disease, skull base osteolysis, and cerebrospinal fluid (CSF) leak developed bacterial meningitis.
  • Initial antibiotic treatment included linezolid and levofloxacin due to beta-lactam allergies.
  • CSF cultures identified penicillin-susceptible Streptococcus mitis, leading to a switch to penicillin G therapy.

Findings:

  • The patient received 14 days of successful antibiotic treatment for Streptococcus mitis meningitis.
  • No neurological sequelae were observed following the treatment.
  • This represents a unique case of pediatric Streptococcus mitis meningitis associated with skull base osteolysis and CSF leak.

Implications:

  • Clinicians should consider Streptococcus mitis as a potential pathogen in pediatric meningitis cases involving skull base osteolysis and/or CSF leaks.
  • Early diagnosis and appropriate antibiotic selection are crucial for favorable outcomes in such rare infections.
  • This case expands the known spectrum of infections caused by the Streptococcus mitis group in immunocompromised pediatric patients.
Keywords:
Gorham-Stout diseaseMeningitisS. mitis group

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