{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:26:19Z","timestamp":1792686379602,"version":"4.5.0"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction and importance<\/jats:title><jats:p>Paroxysmal sympathetic hyperactivity (PSH) syndrome often occurs with severe traumatic brain injury. However, it can also occur during infections, such as severe bacterial meningoencephalitis in children. <jats:italic>Streptococcus intermedius<\/jats:italic> is an aggressive, virulent, opportunistic pathogen. This species can cause meningoencephalitis in children, as reported in a few cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case information<\/jats:title><jats:p>A five-year-old boy with no relevant past medical history was admitted to a hospital because of a fever and progressive disturbance of consciousness. His head computed tomography scan and magnetic resonance imaging revealed extensive brain damage and an intraventricular abscess. A next-generation sequencing technology test performed on his cerebrospinal fluid revealed that the child's meningoencephalitis was caused by <jats:italic>S. intermedius<\/jats:italic>. During treatment, the child had clinical manifestations such as fever, tachycardia, tachypnea, diaphoresis, and hypertension. Changes in muscle tone and abnormal posture, which were misdiagnosed as epilepsy at the early treatment stage, were also observed; however, anti-epileptic treatment was ineffective. The child was diagnosed with PSH and received the appropriate treatment, and his symptoms eventually improved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>To our knowledge, this is the first case report on PSH induced by <jats:italic>S. intermedius<\/jats:italic> meningoencephalitis. Early identification, diagnosis, and treatment of PSH are crucial.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1480514","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T04:32:47Z","timestamp":1733891567000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Paroxysmal sympathetic hyperactivity syndrome caused by Streptococcus intermedius meningoencephalitis in children: a case report and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Qiuling","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoyi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yean","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1089\/neu.2013.3301","article-title":"Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, Nomenclature, and diagnostic criteria","volume":"31","author":"Baguley","year":"2014","journal-title":"J Neurotrauma"},{"key":"B2","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.jiac.2017.09.011","article-title":"Sites of infection associated with Streptococcus anginosus group among children","volume":"24","author":"Furuichi","year":"2018","journal-title":"J Infect Chemother"},{"key":"B3","doi-asserted-by":"publisher","first-page":"826","DOI":"10.3389\/fmicb.2020.00826","article-title":"From normal flora to brain abscesses: a review of Streptococcus intermedius","volume":"11","author":"Issa","year":"2020","journal-title":"Front Microbiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1684\/abc.2019.1421","article-title":"Brain abscess caused by Streptococcus intermedius: a case report","volume":"77","author":"Miloudi","year":"2019","journal-title":"Ann Biol Clin"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e428","DOI":"10.1097\/INF.0000000000003613","article-title":"Streptococcus intermedius acute meningitis in an immunocompetent child","volume":"41","author":"Tkacz","year":"2022","journal-title":"Pediatr Infect Dis J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1097\/PCC.0000000000001811","article-title":"Paroxysmal sympathetic hyperactivity after severe traumatic brain injury in children: prevalence, risk factors, and outcome*","volume":"20","author":"Alofisan","year":"2019","journal-title":"Pediatr Crit Care Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.4037\/ccn2020348","article-title":"Pharmacological treatment for paroxysmal sympathetic hyperactivity","volume":"40","author":"Gilbert","year":"2020","journal-title":"Crit Care Nurse"},{"key":"B8","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1097\/NRL.0000000000000258","article-title":"Treating paroxysmal sympathetic hyperactivity with enteral baclofen in anoxic brain injury","volume":"25","author":"O\u2019Keefe","year":"2020","journal-title":"Neurologist"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1987","DOI":"10.1038\/s41440-024-01691-x","article-title":"Involvement of hydrogen sulfide in the pathogenesis of ischemic stroke-induced paroxysmal sympathetic hyperactivity","volume":"47","author":"Mahmoud","year":"2024","journal-title":"Hypertens Res"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.12890\/2017_000562","article-title":"Paroxysmal sympathetic hyperactivity: an old but unrecognized condition","volume":"4","author":"Monteiro","year":"2017","journal-title":"Eur J Case Rep Intern Med"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1480514\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T04:32:48Z","timestamp":1733891568000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1480514\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,11]]},"references-count":10,"alternative-id":["10.3389\/fped.2024.1480514"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1480514","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,11]]},"article-number":"1480514"}}