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An Editorial Note on Fatal Pediatric Streptococcal Infection: A Clinico-Pathological Study

Anita Nagy, Jeanette A. Reyes, David A. Chiasson

In this study we analysed the clinical and the autopsy findings of 38 pediatric cases, above the age of 28 days, when the death was due to Streptococcal infection. Cases with underlying risk factors for infections, were excluded from the study. The two main infective organisms were Streptococcus pneumoniae (SPn; 45%) and Streptococcus pyogenes (SPy; 37%). Almost all (92%) decedents had some prodromal symptoms prior to death and the majority had a very rapid terminal course: 89% were found unresponsive, suddenly collapsed, or died within 24 hours of hospital admission. Sepsis was the most common immediate cause of death (64%), which was more common in the SPy group than in the SPn group (71% vs. 48%). Pneumonia was found in 18% of the cases with similar number of cases in both SPn and SPy groups (18% vs. 21%). Meningitis, found in 16% of cases, was exclusively caused by SPn. Additional molecular studies of autopsy samples to identify more virulent Streptococcal strains would be a great value to vaccine developments and to prevent sudden and unexpected pediatric deaths related to Streptococcal infection.