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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
PubMed

Insights

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.

Keywords:
Invasive Group A Streptococcusbacterial meningitisintracranial infectionsubdural empyema

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