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Pediatric Invasive Group A Streptococcus Infections with Central Nervous System Involvement: A Single Institution
Natalie Qin1, Justin Morris2, Kelsey Hart3
1Pediatrics Residency Program, Hasbro Children's Brown University Health, Providence, RI.
Rhode Island Medical Journal (2013)
|March 26, 2026
Summary
Pediatric invasive Group A Streptococcus (iGAS) CNS infections are rare but serious. This case series highlights three pediatric iGAS CNS infections in Massachusetts, emphasizing the need for prompt recognition and treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Invasive Group A Streptococcus (iGAS) infections in children, particularly those affecting the central nervous system (CNS), are uncommon but associated with severe outcomes.
- An increase in pediatric iGAS infections, including CNS involvement, has been observed globally post-COVID-19 pandemic.
- Limited regional data exists for pediatric iGAS infections in New England.
Purpose of the Study:
- To describe a unique cluster of three pediatric invasive Group A Streptococcus (iGAS) central nervous system (CNS) infections.
- To highlight the clinical presentation, management, and outcomes of these severe pediatric infections.
- To raise awareness of iGAS as a potential cause of invasive bacterial infections in children, especially in light of rising incidence.
Main Methods:
- A case series describing three pediatric patients with iGAS CNS infections.
- Cases presented within a two-month period in early 2025.
- All cases were geographically clustered within Massachusetts.
Main Results:
- All three patients presented with meningitis and subdural collections on brain imaging.
- Treatment involved prolonged intravenous antibiotics (≥4 weeks), with one patient requiring surgery.
- All patients experienced significant morbidity, including seizures requiring long-term therapy, focal weakness, and developmental delay.
Conclusions:
- Pediatric intracranial iGAS infections are severe and potentially life-threatening.
- The similar presentation, timing, and geographic proximity of these three cases are noteworthy.
- Clinicians should consider GAS as a potential pathogen in pediatric patients with invasive bacterial infections, especially CNS involvement.
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