Streptococcus Advisory for Healthcare Providers

Pediatric Brain Abscesses, Epidural Empyemas, and Subdural Empyemas Associated with Streptococcus Species

Posted June 21, 2022. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.

Summary

CDC is investigating a potential increase in pediatric brain abscesses and epidural and subdural empyemas associated with Streptococcus spp. beginning in June 2021 and ongoing. If you have potential cases, please hold associated clinical specimens and bacterial isolates and email cdepi@srhd.org for reporting information.

Full Information

CDC is investigating a potential increase in pediatric brain abscesses and epidural and subdural empyemas associated with Streptococcus species, including but not limited to Streptococcus anginosus group (S. intermedius, S. anginosus, S. constellatus) and Streptococcus pneumoniae. S. anginosus group may also be classified as viridans Streptococcus or Streptococcus milleri group.

In May 2022, CDC was notified of three children at a hospital system in California with brain abscess, epidural empyema, or subdural empyema caused by S. intermedius. Discussions with several other children’s hospitals identified additional health systems in multiple states that similarly reported a possible increase over baseline in brain abscesses and intracranial infections over the past year; these cases often followed episodes of sinusitis or upper respiratory infection. CDC is requesting that sites report cases and hold associated clinical specimens and bacterial isolates. These data will be used to assess the scope, magnitude, and geographic distribution of this potential increase, and to investigate possible causes.

CDC is asking healthcare providers and health departments to report the occurrence of brain abscess, epidural empyema, and/or subdural empyema in persons aged ≤18 years without a prior history of neurosurgical procedures or head trauma, hospitalized on or after June 1, 2021. Healthcare providers and health departments are encouraged to report cases that are associated with streptococcal infection, due to other bacterial pathogens, polymicrobial, or have no pathogen identified.

If you have potential cases, please hold associated clinical specimens and bacterial isolates and email cdepi@srhd.org for reporting information.