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Updated: Sep 18, 2025

Visualization of Streptococcus pneumoniae within Cardiac Microlesions and Subsequent Cardiac Remodeling
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Spectrum of Central Nervous System Disease Caused by Streptococcus anginosus Group: A Single-Center Case Series

Jennifer Meylor1, Raquel Farias-Moeller2, Niyati Mehta2

  • 1Department of Neurology, Division of Pediatric Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin.

Pediatric Neurology
|June 24, 2025
PubMed

Insights

Pediatric central nervous system infections from Streptococcus anginosus group (SAG) often present with acute symptoms and intracranial abscesses. While prognosis is generally favorable, some children experience neurological and psychological deficits post-PICU admission.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neurophysiology

Background:

  • Central nervous system (CNS) infections in children can lead to significant morbidity.
  • Streptococcus anginosus group (SAG) is an emerging pathogen causing CNS infections.

Purpose of the Study:

  • To characterize the electrophysiologic and neurological outcomes of pediatric CNS infections caused by SAG.
  • To understand the clinical presentation and sequelae of SAG CNS infections in children.

Main Methods:

  • Retrospective case series of 15 pediatric patients admitted to the pediatric intensive care unit (PICU).
  • Analysis of clinical data, neuroimaging, and electroencephalography (EEG) findings.
  • Neurological and neuropsychological assessments at discharge.

Main Results:

  • Most patients were previously healthy with acute onset of fever, headache, and fatigue.
  • Subdural or epidural empyema was the most common CNS complication (93%).
  • Seizures occurred in 47% of patients, with 20% experiencing subclinical seizures; 33% had residual neurological deficits, and neuropsychological testing revealed emotional and cognitive difficulties.

Conclusions:

  • Pediatric CNS infections due to SAG typically present with nonspecific symptoms and intracranial abscesses.
  • While prognosis is often favorable, a significant proportion of children experience neurological and psychological deficits.
  • Continuous EEG monitoring and comprehensive neuropsychological assessment are crucial for managing these patients.
Abstract

Keywords:
Brain abscessContinuous EEGOutcomesPediatricSeizuresSinusitis

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