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Review
. 2023 Jul 23;12(7):1222.
doi: 10.3390/antibiotics12071222.

Streptococcus mitis as a New Emerging Pathogen in Pediatric Age: Case Report and Systematic Review

Claudia Colomba  1   2 , Valeria Garbo  1 , Giovanni Boncori  1 , Chiara Albano  1 , Sara Bagarello  1 , Anna Condemi  1 , Salvatore Giordano  2 , Laura A Canduscio  2 , Cristina Gallo  3 , Gaspare Parrinello  1 , Antonio Cascio  1   4
Affiliations
Review

Streptococcus mitis as a New Emerging Pathogen in Pediatric Age: Case Report and Systematic Review

Claudia Colomba et al. Antibiotics (Basel). .

Abstract

Streptococcus mitis, a normal inhabitant of the oral cavity, is a member of Viridans Group Streptococci (VGS). Generally recognized as a causative agent of invasive diseases in immunocompromised patients, S. mitis is considered to have low pathogenic potential in immunocompetent individuals. We present a rare case of sinusitis complicated by meningitis and cerebral sino-venous thrombosis (CSVT) caused by S. mitis in a previously healthy 12-year-old boy with poor oral health status. With the aim of understanding the real pathogenic role of this microorganism, an extensive review of the literature about invasive diseases due to S. mitis in pediatric patients was performed. Our data define the critical role of this microorganism in invasive infections, especially in immunocompetent children and in the presence of apparently harmful conditions such as sinusitis and caries. Attention should be paid to the choice of therapy because of VGS's emerging antimicrobial resistance patterns.

Keywords: S. mitis; VGS; invasive disease; pediatric.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Oral cavity of the patient at the time of admission. Presence of destructive caries in the upper dental arch.
Figure 2
Figure 2
Contrast-enhanced brain MRI axial (a) and coronal (b) FSE T2w sinusitis of both sphenoid sinuses (a), right maxillary and frontal sinus, and ipsilateral ethmoidal cells (b); (c) Inhomogeneous opacification of the left cavernous sinus; (d) Defect of opacification of the right sigmoid sinus (arrow) as for partial thrombosis. Right sphenoid sinus and maxillary sinus sinusitis (double arrow).
Figure 3
Figure 3
Second contrast-enhanced brain MRI. Coronal (a) and Axial (b) 3D FSPGR defect of opacification of both jugular veins (arrows); (b) right maxillary sinusitis (double arrows).
Figure 4
Figure 4
Control MRI post discharge axial 3D FSPGR resolution of jugular vein thrombosis.
Figure 5
Figure 5
PRISMA study flow diagram: flow diagram of study identification, screening, eligibility, and included studies.
Figure 6
Figure 6
Most frequent invasive condition caused by S. mitis in our review: number of cases and percentage. BSI: bloodstream infections, CNSI: central nervous system infections, MSK: musculoskeletal.
See this image and copyright information in PMC

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