Invasive Group A Streptococcal Meningitis Following COVID-19 Infection Complicated by Multisystem Inflammatory

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Saya Hiramine1, Yudai Tanaka2, Chiaki Sano3

  • 1Family Medicine, International University of Health and Welfare, Graduate School of Health Welfare Sciences, Tokyo, JPN.

Cureus
|November 20, 2024
PubMed

Insights

A COVID-19 patient developed invasive group A streptococcal meningitis and multisystem inflammatory syndrome. Early diagnosis and aggressive antibiotic treatment are crucial for preventing severe complications.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Critical Care Medicine

Background:

  • COVID-19 can predispose patients to secondary bacterial infections.
  • Multisystem Inflammatory Syndrome (MIS) in adults presents with diverse and sometimes atypical symptoms.
  • Group A Streptococcus (GAS) is a significant bacterial pathogen.

Observation:

  • A 60-year-old woman with COVID-19 developed persistent sore throat, progressing to bacterial pneumonia, dehydration, and sepsis.
  • She subsequently presented with symptoms suggestive of meningitis, including headache and shivering.
  • Cerebrospinal fluid analysis confirmed bacterial meningitis, and an MRI revealed a parapharyngeal abscess.

Findings:

  • Blood cultures identified Group A Streptococcus (GAS) as the causative agent of meningitis.
  • The patient received a combination of intravenous antibiotics (ceftriaxone, ampicillin, vancomycin) followed by oral amoxicillin.
  • Successful treatment led to resolution of meningitis and abscess without neurological deficits.

Implications:

  • This case highlights the importance of considering secondary GAS meningitis in post-COVID-19 patients, particularly those with MIS.
  • Vigilance for atypical presentations is essential for timely diagnosis and management of invasive bacterial infections.
  • Prompt and appropriate antibiotic therapy is critical for favorable outcomes and preventing long-term sequelae.
Keywords:
bacterial meningitiscovid-19family medicinegeneral medicineimmunosuppressionmultisystem inflammatory syndromeolderparapharyngeal abscessruralstreptococcus pyogenes

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