June 1980

Group A β-Hemolytic Streptococci Causing Pyogenic Gingival Cyst in Infancy

Author Affiliations

Department of Pediatrics Georgetown University Hospital 3800 Reservoir Rd, NW Washington, DC 20007

Am J Dis Child. 1980;134(6):617-618. doi:10.1001/archpedi.1980.02130180073020

Localized gingival lesions in young febrile, irritable infants have recently been described, often in association with occult pneumococcal bacteremia. A review of the literature discloses eight such reported cases, many of which had concomitant ipsilateral buccal cellulitis.1-3 This constellation of symptoms has been so typical that Yeager3 suggested the presence of a cystic gingival lesion in a febrile infant with leukocytosis (1) should alert the clinician to the distinct possibility of concomitant pneumococcal bacteremia and (2) seems to be pathognomonic for this bacteremia. Recently, we cared for a febrile infant who had a cystic gingival lesion, mimicking a hemorrhagic preeruption dentigerous cyst, from which a pure growth of group A β-hemolytic streptococcus was obtained. The purpose of this report is to alert the pediatrician to the entity of a pyogenic gingival cyst of infancy and to stress the importance of aggressive diagnosis and antimicrobial therapy. We emphasize the