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Microorganisms
Volume 13
Issue 5
10.3390/microorganisms13051100
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Systematic Review

Unraveling Pediatric Group A Streptococcus Meningitis: Lessons from Two Case Reports and a Systematic Review

by
Lavinia Di Meglio
1,*,
Maia De Luca
2,*,
Laura Cursi
2,
Lorenza Romani
2,
Mara Pisani
3,
Anna Maria Musolino
3,
Stefania Mercadante
2,
Venere Cortazzo
4,
Gianluca Vrenna
4,
Paola Bernaschi
4,
Roberto Bianchi
5 and
Laura Lancella
2
1
School of Pediatrics, University of Rome Tor Vergata, 00133 Rome, Italy
2
Infectious Diseases Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
3
Hospital University Pediatrics Clinical Area, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
4
Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
5
Anaesthesia, Emergency and Pediatric Intensive Care Unit, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
*
Authors to whom correspondence should be addressed.
Microorganisms 2025, 13(5), 1100; https://doi.org/10.3390/microorganisms13051100
Submission received: 8 March 2025 / Revised: 12 April 2025 / Accepted: 16 April 2025 / Published: 9 May 2025
(This article belongs to the Special Issue Diagnosis, Characterization and Treatment of Emerging Pathogens, Second Edition)
Review Reports Versions Notes

Abstract

Streptococcus pyogenes meningitis is a rare invasive disease, accounting for less than 2% of bacterial meningitis. We presented two case reports and conducted a systematic review using PUBMED, covering the database from its inception up to 31 December 2024, of pediatric cases of Streptococcus pyogenes meningitis. Only case reports and case series were included. Differences in clinical and laboratory parameters were compared between uneventful course and complicated admissions. A total of 57 cases were included. The median age at diagnosis was 4 years. A primary infection focus outside the brain was identified in 61.39% of cases. S. pyogenes was identified from cerebrospinal fluid in 66.66% of cases and from blood in 15.79%. Septic shock occurred in 24.56% of cases, and 36.84% had brain anatomical anomalies. All patients received broad-spectrum empiric antibiotics, while protein-synthesis inhibitors were administered in 26.31% of cases. A total of 17% of patients died, and 28.07% experienced sequelae. The identification of S. pyogenes from blood and a Phoenix Sepsis Score ≥ 2 were significantly associated with a complicated clinical course. Our findings may offer useful insights for the clinical management of Streptococcus pyogenes meningitis.
Keywords: Streptococcus pyogenes; meningitis; children; pediatrics; group A streptococcus; GAS Streptococcus pyogenes; meningitis; children; pediatrics; group A streptococcus; GAS

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MDPI and ACS Style

Di Meglio, L.; De Luca, M.; Cursi, L.; Romani, L.; Pisani, M.; Musolino, A.M.; Mercadante, S.; Cortazzo, V.; Vrenna, G.; Bernaschi, P.; et al. Unraveling Pediatric Group A Streptococcus Meningitis: Lessons from Two Case Reports and a Systematic Review. Microorganisms 2025, 13, 1100. https://doi.org/10.3390/microorganisms13051100

AMA Style

Di Meglio L, De Luca M, Cursi L, Romani L, Pisani M, Musolino AM, Mercadante S, Cortazzo V, Vrenna G, Bernaschi P, et al. Unraveling Pediatric Group A Streptococcus Meningitis: Lessons from Two Case Reports and a Systematic Review. Microorganisms. 2025; 13(5):1100. https://doi.org/10.3390/microorganisms13051100

Chicago/Turabian Style

Di Meglio, Lavinia, Maia De Luca, Laura Cursi, Lorenza Romani, Mara Pisani, Anna Maria Musolino, Stefania Mercadante, Venere Cortazzo, Gianluca Vrenna, Paola Bernaschi, and et al. 2025. "Unraveling Pediatric Group A Streptococcus Meningitis: Lessons from Two Case Reports and a Systematic Review" Microorganisms 13, no. 5: 1100. https://doi.org/10.3390/microorganisms13051100

APA Style

Di Meglio, L., De Luca, M., Cursi, L., Romani, L., Pisani, M., Musolino, A. M., Mercadante, S., Cortazzo, V., Vrenna, G., Bernaschi, P., Bianchi, R., & Lancella, L. (2025). Unraveling Pediatric Group A Streptococcus Meningitis: Lessons from Two Case Reports and a Systematic Review. Microorganisms, 13(5), 1100. https://doi.org/10.3390/microorganisms13051100

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