Since the mid-1980s, there has been an increasing incidence of invasive infections caused by group A β-hemolytic streptococcus (GAS).1 Invasive GAS infections are defined by the isolation of GAS from a normally sterile site in the setting of bacteremia without a focus or focal infections with or without bacteremias, including meningitis, pneumonia, peritonitis, puerperal fever, osteomyelitis, septic arthritis, necrotizing fasciitis, surgical wound infections, erysipelas, and cellulitis.2 Conditions associated with increased risk of invasive GAS include human immunodeficiency virus, malignant neoplasm, heart or lung disease, diabetes mellitus, and alcoholism.1 Meningitis caused by this organism is still very rare and accounts for less than 1% of all meningitides.3 We recently treated a middle-aged woman who developed meningitis after untreated otitis media and recovered fully.
Asnis DS, Knez T. Group A Streptococcal Meningitis. Arch Intern Med. 1998;158(7):810–814. doi:
Best of JAMA Network 2022
Customize your JAMA Network experience by selecting one or more topics from the list below.