Children with Intracranial Infections Associated with Streptococcus Bacteria
- CDC is investigating a possible increase in intracranial (within the head) infections in children.
- Streptococcus bacteria have been identified in most cases, with Streptococcus intermedius being the most common cause. However, many other bacteria have been 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.
- A preliminary analysis of hospitalizations from a wide range of children’s hospitals across the United States has not found an increase in intracranial infections in children. Additional analyses are ongoing and results may change, but the preliminary data are reassuring.
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 appear 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. However, a preliminary analysis of hospitalizations from a wide range of children’s hospitals across the United States did not find an increase in intracranial infections in children (unpublished data, Pediatric Health Information System [PHIS], through a collaboration with the Children’s Hospital Association [CHA]).
Additional analyses are ongoing and results may change, but the preliminary data are reassuring. More data are being collected through a national request for cases that went out June 9, 2022.
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), have been found in similar infections being 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. During this investigation, the number of children reported to have these infections will likely increase as cases are reported to CDC.
What CDC is doing
CDC is working with state and local health departments, academic partners, and clinicians to see how common these cases are and what could be done to prevent them. Health officials are examining
- 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
CDC and state public health officials will continue to work in close collaboration with clinicians and academic partners to identify and detect unusual patterns or clusters of intracranial infections in children.
CDC has developed testing guidance for clinicians and laboratorians.