Complications of Otitis Media and Sinusitis Caused by Streptococcus anginosus Group Organisms in Children.

McNeil et al. from Texas Children'sHospital studied 95 children seen between 2011 to 2018 with complications of otitis media and sinusitis caused by Streptococcus anginosus Group (SAG) organisms.  SAG are nonmotile facultative anaerobes that are part of the normal oral cavity, throat, stool, and vagina flora. Cases included 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 stain)