By Ethan Covey
Concern about an increase in cases of pediatric brain abscess, epidural empyema and subdural empyema caused by Streptococcus intermedius are unfounded, according to a recent CDC report.
Cases reported to the CDC during May 2022, and discussions with clinicians across the United States, had raised alarms that these rare abscesses and empyemas had been increasing, possibly due to the COVID-19 pandemic (MMWR Morb Mortal Wkly Rep 2022;71[37]:1169-1173).
Officials at the CDC analyzed data from pediatric hospitalizations for brain abscesses, epidural empyemas and subdural empyemas reported to the Children’s Hospital Association’s Pediatric Health Information System, as well as those reported to the CDC following a national call for cases.
They found an increase in pediatric brain abscesses and empyemas starting in late 2021, which was consistent with reports made to the CDC, but also saw this increase was balanced out by an extended period of low numbers of cases starting in April 2020.
“This trend is possibly due to the steps people were taking to limit the spread of COVID-19, which also limited the spread of other viruses and bacteria, followed by the relaxation of these measures,” said Emma K. Accorsi, PhD, an epidemic intelligence service officer in the Respiratory Diseases Branch, Division of Bacterial Diseases at the CDC’s National Center for Immunization and Respiratory Diseases, in Atlanta.
Overall, the total number of cases for 2021—the last year with complete data—was similar to what would typically be expected.
“Pediatric brain abscess and empyema are rare infections—a hospital may only see a few cases per year—and not routinely reported to public health officials, making them challenging to study,” Dr. Accorsi said. “Through collaboration, we were able to rapidly analyze many different types of data, including nationally representative hospitalizations for these conditions over time, pathogen genomics and antimicrobial resistance profiles, and measures of disease severity.”
She noted that the findings from these data sources compared similarly to what would normally be anticipated.
The study found evidence of seasonal patterns in pediatric brain abscesses and empyemas, particularly high levels found during March 2022, which had not been previously reported. Additionally, it was determined that patterns of pediatric brain abscesses and empyemas changed during the COVID-19 pandemic. Yet, the total number of cases between April 2020 and the end of the study period was not higher than expected.
