Di Meglio Lavinia, De Luca Maia, Cursi Laura, Romani Lorenza, Pisani Mara, Musolino Anna Maria, Mercadante Stefania, Cortazzo Venere, Vrenna Gianluca, Bernaschi Paola, Bianchi Roberto, Lancella Laura
School of Pediatrics, University of Rome Tor Vergata, 00133 Rome, Italy.
Infectious Diseases Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Microorganisms. 2025 May 9;13(5):1100. doi: 10.3390/microorganisms13051100.
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. 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 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.
脑膜炎是一种罕见的侵袭性疾病，占细菌性脑膜炎的比例不到2%。我们报告了两例病例，并使用PUBMED进行了系统综述，涵盖了从数据库建立到2024年12月31日的化脓性链球菌脑膜炎儿科病例。仅纳入病例报告和病例系列。比较了病情平稳和复杂入院病例的临床和实验室参数差异。共纳入57例病例。诊断时的中位年龄为4岁。61.39%的病例发现脑外有原发性感染灶。66.66%的病例脑脊液中检出[病原体名称未给出]，15.79%的病例血液中检出。24.56%的病例发生感染性休克，36.84%有脑解剖异常。所有患者均接受了广谱经验性抗生素治疗，26.31%的病例使用了蛋白质合成抑制剂。共有17%的患者死亡，28.07%出现后遗症。血液中检出[病原体名称未给出]以及Phoenix脓毒症评分≥2与复杂的临床病程显著相关。我们的研究结果可能为化脓性链球菌脑膜炎的临床管理提供有用的见解。
