Streptococcus pyogenes is a very uncommon cause of bacterial meningitis bey
ond the neonatal period. A case report and a review of the recent literatur
e is presented. We report on a previously healthy 7-year-old boy who develo
ped S. pyogenes meningitis following a 2-day history of otitis media. A CT
scan revealed right-sided mastoiditis as a possible focus of infection. The
patient was treated with penicillin G for 14 days. The clinical course was
uneventful, and he recovered without sequelae. By means of the polymerase
chain reaction, the presence of streptococcal pyrogenic exotoxin (SPE) B an
d SPE C, but not SPE A genes was discovered from the bacterial DNA.
Conclusion Streptococcus pyogenes is a rare cause of bacterial meningitis b
ut has to be considered as the causative pathogen beyond the neonatal perio
d.