Children with Intracranial Infections Associated with Streptococcus Bacteria
Investigation Overview
Clinicians, public health professionals, and parents can find more information at Children with Intracranial Infections Associated with Streptococcus Bacteria .
- CDC investigated a possible increase in intracranial (within the head) 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.
- S. intermedius is known to cause these types of rare infections in children.
In May 2022, CDC was notified of three children at a hospital in California with intracranial (within the head) 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.
The children were from different parts of the state. No known contact or common exposures were found among the children. None of these children appeared to have had significant underlying medical conditions or previous surgeries on their brain, head, or neck.
Based on the cases from California and information gathered from additional health systems, investigators were concerned that there may be an 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 found
- Cases declined at the beginning of the COVID-19 pandemic.
- This is possibly due to the steps people were taking to limit the spread of COVID-19, which also limited the spread of other viruses and bacteria.
- Cases began increasing in summer 2021 and continued through March 2022.
- The number of cases was never more than what could have been expected based on past patterns of disease.
- In addition, the cases were not more serious, deadly, or resistant to antibiotics than cases prior to the pandemic.
- Cases began declining in April 2022 and have returned to levels expected for this time of year.
Learn more about a survey conducted through the Emerging Infections Network, which asked about an increase in intracranial infections or invasive Streptococcus species.
About Streptococcus bacteria and intracranial infections
S. intermedius, and Streptococcus bacteria more generally, are known to cause these types of intracranial infections.
Laboratory tests identified S. intermedius in specimens collected from each of the 3 patients from California. This type of bacteria, and other types of Streptococcus bacteria (e.g., S. pneumoniae, S. anginosus, S. constellatus), were found in similar infections investigated in other states.
S. intermedius and other types of Streptococcus bacteria are known to cause intracranial infections in children.
Prevalence (number of cases)
Streptococcal intracranial infections are not routinely reported to public health. Therefore, it is not yet clear how many cases have been diagnosed in children over the past year and before.
What CDC did
Investigation
CDC worked with state and local health departments, academic partners, and clinicians to see how common these cases were and what could be done to prevent them. Health officials examined
- Medical records of children who had these infections in the past
- National data sources to look at trends in intracranial infections in children, including before the COVID-19 pandemic
- Bacterial isolates from patients with possible cases