McNeil et al. from Texas Children's Hospital studied 95 children seen between 2011 to 2018 with complications of
otitis media and sinusitis caused by Streptococcus anginosus Group (SAG) organisms.
Cases were those with Pott's
puffy tumor, orbital abscesses, mastoiditis, epidural abscesses, subdural
empyema, brain parenchymal abscesses or dural enhancement by imaging.
Streptococcus intermedius was most commonly isolated
(80%) followed by Streptococcus constellatus (12.6%) and Streptococcus anginosus (7.4%); 50.5% of
cases were polymicrobial. Among polymicrobial cases, Staphylococcus aureus was
most frequently isolated. All patients underwent surgical intervention and 8.4%
had persistent neurologic deficits. Complications of otitis media and sinusitis
caused by SAG are associated with substantial morbidity.
The researchers concluded that intraorbital
and intracranial infections in general and SAG in particular are becoming
increasingly common at their medical center.
Streptococcus anginosus Gram staining