A case report of multiple abscesses caused by Streptococcus intermedius

• Published in: Clinical case reports Vol. 11; no. 1; pp. e6813 - n/a
• Main Authors: Reyes, Jonathan Vincent M., Dondapati, Manasa, Ahmad, Saad, Song, David, Lieber, Joseph J., Pokhrel, Nishan Babu, Jaiswal, Vikash
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-01-2023; John Wiley and Sons Inc; Wiley
• Subjects: Abdomen; Abscesses; Antibiotics; Biofilms; Cardiovascular disease; Case Report; Case reports; Congenital diseases; Coronaviruses; COVID-19; Dental caries; Diabetes; Enzymes; Heart; Hospitals; Infections; Laboratories; Liver; Mortality; Neurosurgery; Organisms; pathology; Patients; Pleural effusion; Pneumonia; Risk factors; Sinusitis; Streptococcus infection; Streptococcus infections; Virulence; abscesses; Streptococcus infection; pathology
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.6813

Streptococcus intermedius is a beta‐hemolytic, non‐motile, catalase‐negative, gram‐positive member of the Streptococcus anginosus group. When compared to other members of this group like S. anginosus and Streptococcus constellatus, S. intermedius infections are more substantial. In this case, we present a 47‐year‐old male patient who was found to have S. intermedius abscesses in his lungs, liver, and brain. The treatment of choice for these abscesses is a combination of drainage, surgery, and antibiotic therapy.
Streptococcus intermedius has a unique tropism in the brain, liver, and lungs leading to abscess formation. When compared to other members of this group like Streptococcus anginosus and Streptococcus constellatus, S. intermedius infections are more substantial. S. intermedius is unique to the other bacteria in SAG due to the expression of intermedilysin (ILY), allowing it to cause cell necrosis with membrane bleb formation. The mortality rate for SAG‐associated bacteremia is 10%–16%. Early recognition and timely intervention are important for successful treatment and improved outcomes. There are currently no screening guidelines when S. intermedius is found in culture data; however, clinicians should have a low threshold to consider imaging for indolent infections.