Meningitis with bilateral acute suppurative otitis media caused by Group A streptococcus.

Group A streptococcal (GAS) invasive disease has become increasingly common in recent years but meningitis caused by GAS is still relatively uncommon(1). Recently, severe and fulminant cases of Group A streptococcal meningitis have been reported(2) but it is rather an uncommon organism causing meningitis beyond neonatal period(3). We report a 10-year-old child with bilateral otitis media leading on to Group A streptococcal meningitis with a dramatically rapid course and fatal outcome. A previously healthy 10 year old boy with a past history of purulent ear discharge from the left ear was admitted to our hospital with the chief complaint of generalized headache and moderate to high grade fever for the last 10 days. Along with the headache he had four to five episodes of vomiting which were non-bilious and nonprojectile during the last 5 days. He became lethargic and drowsy 2 hours prior to admission. However, there was no history of seizures, trauma, focal deficit or cyanosis.