Multifocal brain abscesses caused by invasive Streptococcus intermedia: A case report

Abstract

Multifocal brain abscesses caused by invasive Streptococcus intermedia are relatively rare. Here, we present a 67-year-old male was admitted to the hospital for unconsciousness and fever. The computed tomography (CT) examination showed multiple intracranial space-occupying and “cavity-like” changes in the right lower lung. The examination of cerebrospinal fluid (CSF) was consistent with typical bacterial meningitis, CSF analyses revealed leukocytosis (10,300 × 106/L), elevated protein levels (140.39 mg/dL), decreased glucose levels (0.27 mmol/L), and normal chloride concentration level (120.2 mmol/L), however, pathogens were not detected in the cultures. Then, the CSF and sputum samples were analyzed using meta-genomic next-generation sequencing (mNGS), and S. intermedia was detected in both samples. We adjusted the use of antibiotics according to the results of mNGS in time. After anti-infective treatment, the patient achieved good treatment results in a very short time. This case highlights the mNGS can identify pathogens of brain abscess, and provide strong evidence for clinical diagnosis and treatment strategy.

A Report of Two Cases of Meningoencephalitis Caused by Streptococcus intermedius

“… 17 Previous research found that S. intermedius infections were present in the cerebrospinal fluid of a 67-year-old man who presented with coma and fever. 18 Meningoencephalitis caused by S. intermedius is relatively difficult to distinguish from tuberculous meningoencephalitis based on clinical manifestations and results of cerebrospinal fluid and MR imaging. Therefore, the diagnosis of this disease requires cerebrospinal fluid biochemistry, microscopic examination, culture, and PCR detection of bacterial DNA.…”

Is Metagenomics the Future Routine Diagnosis Tool for Brain Abscesses? About a Case

“…A literature review on SMg use for brain abscesses microbiological documentation retrieved only fifteen other cases published as case reports or short series [16][17][18][19][20][21][22][23][24][25][26][27][28]. Most sampling was conducted after the start of the antibiotics, which affected conventional culture.…”

Multifocal Brain Abscesses Due to Streptococcus intermedius

“…Brain abscess can be secondary to direct spread or hematogenous seeding of infection. While hematogenous spread commonly leads to multiple lesions, multifocal brain abscesses secondary to Streptococcus intermedius are rare presentations [ 4 ]. While Streptococcus and Staphylococcus spp.…”