Clinical Guidance for Children with Intracranial Infections Associated with Streptococcus bacteria
- CDC investigated a possible increase in intracranial infections in children.
- An analysis of hospitalizations and data received from a wide range of children’s hospitals and providers across the United States did not find a concerning increase in intracranial infections in children.
- Streptococcus bacteria were identified in most cases, with Streptococcus intermedius being the most common cause. However, many other bacteria were identified, and brain abscesses are often caused by infection with multiple bacteria.
In May 2022, CDC was notified of three children at a hospital in California with intracranial infections caused by Streptococcus intermedius. All the children were previously healthy and ranged in age from 11 to 13 years old at the time of hospitalization. Based on the cases from California and information gathered from additional health systems, investigators were concerned that there may be an increase in pediatric intracranial infections. However, an analysis of hospitalizations and data received from a wide range of children’s hospitals and providers across the United States did not find a concerning increase in pediatric intracranial infections.
Learn more about the investigation.
About Streptococcus bacteria causing intracranial infections
S. intermedius rarely causes illness but is known to cause abscesses and subdural and epidural empyemas. These bacteria most commonly cause abscesses in the liver and brain. They can also cause endocarditis. S. intermedius can affect people of all ages and cause severe illness in otherwise healthy people.
S. pneumoniae can cause many types of infections, ranging from otitis media and sinusitis to pneumonia, bacteremia, and meningitis. Most pneumococcal infections are mild, but some can be severe. Anyone can get pneumococcal disease but being younger than 2 years old or 65 years or older or having certain medical conditions can increase risk.
Learn more about pneumococcal disease.
Transmission
Pathogens that can cause intracranial infections, such as S. intermedius, are commonly found in the nose, mouth, and throat. These bacteria can enter the body and spread to the brain or the subdural or epidural space
- Through the bloodstream from an infection in other parts of the body, such as ears, eyes, sinuses, or teeth
- By entering the brain or subdural or epidural space directly through an open wound in the head
Diagnosis
To confirm a brain abscess or epidural or subdural empyema, use diagnostic tests, such as
- Magnetic resonance imaging (MRI)
- Computed tomography (CT) scan
- Blood tests
- Lumbar puncture
Treatment
Treat brain abscesses and subdural and epidural empyemas with surgery and antibiotics.
Complications
Even with treatment, intracranial infections can sometimes lead to
- Long-term neurological problems, such as nerve damage resulting in weakness or paralysis
- Sepsis
- Death, especially if not promptly treated