S treptococcus oralis is a viridans streptococcus that is divided into 3 subspecies S. oralis subsp. oralis, dentisani, and tigurinus (1). Differentiation between these subspecies and other α-hemolytic streptococci, including S. pneumoniae, remains difficult because they share similar biochemical properties. S. oralis inhabits the oral cavity and can cause severe infections in persons with immunodeficiency (2). Antimicrobial drug resistance and capsule expression studies have demonstrated that gene transfer can occur from oral Streptococcus spp. to S. pneumoniae (3-5). Most oral Streptococcus spp. have a pneumococcus-like capsule locus and produce capsular polysaccharides (6).We report 2 cases of invasive streptococcal disease in older adults in Japan (Table ). Case 1 occurred in a 69-year-old man with gastric cancer; case 2 occurred in a 78-year-old man with bacteremic meningitis who had no underlying disease. Both patients were successfully treated with antimicrobial agents. The bacterial isolates (ASP0312-Sp from case 1 and SP2752 from case 2) contained α-hemolytic bacteria that formed characteristic mucoid colonies on blood agar (Table ). Quellung reactions were strongly positive for pool R or pneumococcal serotype 3 antisera (Statens Serum Institut, https://en.ssi.dk), suggesting that the isolates were S. pneumoniae serotype 3. However, both isolates were optochin-resistant and bile-insoluble. Moreover, multilocus sequence