Pyogenic Brain and Lung Abscesses Due to Streptococcus intermedius

Trabue, Christopher; Pearman, Ryan; Doering, Tracey

doi:10.1007/s11606-013-2565-3

Cited by 15 publications

(15 citation statements)

References 3 publications

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“…He had recurrent pneumonia most likely from aspiration during his binge drinking. The development of lung and brain abscesses from S. intermedius in a young patient with substance abuse has been previously reported by Traube et al [ 5 ]. We believe that S. intermedius , a part of oral flora, was aspirated during these episodes and led to pneumonia.…”

Section: Discussionmentioning

confidence: 55%

Conglomerate mediastinal mass of a different etiology

Hameed

Singh

Tricia

et al. 2017

Oxford Medical Case Reports

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Streptococcus intermedius is a Gram-positive commensal of the oral cavity with tendency to cause brain and liver abscesses. Mediastinal involvement from S. intermedius is very rare. We present a case of 22-year-old male with newly detected mediastinal conglomerate nodal mass. On his way for bronchoscopy, he developed seizures and was found to have three brain lesions. The aspirate from brain biopsy grew S. intermedius whereas the aspirate from mediastinum showed only acute inflammation. Follow up imaging after antibiotic treatment showed interval resolution of brain abscesses and the mediastinal mass. We believe that the patient had aspiration pneumonia from S. intermedius which then metastasized to mediastinum and brain. Our aim is to make physicians aware of this unusual presentation of S. intermedius infection as a mediastinal mass. A strong effort should be made to isolate the organism from the involved body sites and fluid cavities to confirm the diagnosis.

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Section: Discussionmentioning

confidence: 55%

Conglomerate mediastinal mass of a different etiology

Hameed

Singh

Tricia

et al. 2017

Oxford Medical Case Reports

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“…Although a positive CSF bacterial culture and other signs of bacterial meningitis were absent from our patient, we could not completely rule out the possibility of Streptococcus intermedius meningitis since an abnormal fluid accumulation in the dependent portion of the bilateral lateral ventricle typically suggested pyogenic ventriculitis [12]; in addition, concomitant Streptococcus intermedius brain and lung abscess had been reported previously [13,14]. The pyogenic ventriculitis is rare and usually severe, and often causes obvious meningitis signs.…”

Section: Discussionmentioning

confidence: 60%

Differential diagnosis of atypical encephalopathy in critical care: a case report

Peng

Chang

et al. 2020

BMC Infect Dis

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Background A lower level of consciousness is a common presentation in critical care, with many different causes and contributory factors, of which more than one may be present concurrently. Case presentation We described a woman with poorly controlled diabetes and steroid-dependent asthma who presented in a deep coma. She was found to have Streptococcus intermedius bacteremia and pyogenic ventriculitis that originated from right middle lobe pneumonia. Also, multiple small parenchymal lesions were observed on brain magnetic resonance imaging and increased protein concentration was noted in cerebral spinal fluid. Initially, her coma was thought to be due to diabetic ketoacidosis and septic encephalopathy. However, her lowered level of consciousness was disproportionate to either diabetic ketoacidosis or septic encephalopathy, and her clinical course was not as expected for these two conditions. Treatment with antibiotic, corticosteroid and antihelminthic drugs was administered resulting in improving consciousness. The Streptococcus intermedius pneumonia progressed to form a large cavity that needed an early surgical lobectomy and resulted in the unexpected diagnosis of chronic cavitary pulmonary aspergillosus. Conclusions In critical care, a lowered level of consciousness may have many etiologies, and critical care clinicians should be familiar with the signs and symptoms of all possible causes to enable prompt diagnosis and appropriate treatment.

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“…CD59 is also the membrane receptor for intermedilysin (ILY), the CDC toxin from the human commensal Streptococcus intermedius that has been implicated in abscess formation in the brain, the liver and the lung [173]. Strikingly, CD59 prevents pore formation by the MAC, but enables it when the structurally homologous ILY is present.…”

Section: Inhibition Of Mac Assemblymentioning

confidence: 99%

Structural Biology of the Membrane Attack Complex

Sonnen

Henneke

2014

MACPF/CDC Proteins - Agents of Defence, Attack and Invasion

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The complement system is an intricate network of serum proteins that mediates humoral innate immunity through an amplification cascade that ultimately leads to recruitment of inflammatory cells or opsonisation or killing of pathogens. One effector arm of this network is the terminal pathway of complement, which leads to the formation of the membrane attack complex (MAC) composed of complement components C5b, C6, C7, C8 and C9. Upon formation of C5 convertases via the classical or alternative pathways of complement activation, C5b is generated from C5 by proteolytic cleavage, nucleating a series of association and polymerisation reactions of the MAC-constituting complement components that culminate in pore formation of pathogenic membranes. Recent structures of MAC components and homologous proteins significantly increased our understanding of oligomerisation, membrane association and integration, shedding light onto the molecular mechanism of this important branch of the innate immune system.

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Pyogenic Brain and Lung Abscesses Due to Streptococcus intermedius

Cited by 15 publications

References 3 publications

Conglomerate mediastinal mass of a different etiology

Conglomerate mediastinal mass of a different etiology

Differential diagnosis of atypical encephalopathy in critical care: a case report

Structural Biology of the Membrane Attack Complex

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