Streptococcus intermedius: unusual presentation and complication of lung abscess

Abstract

We report a case of a 54-year-old immunocompetent male who had lung abscess secondary to Streptococcus intermedius that led to discitis by contiguous spread of infection. He initially presented with constant chest pain for 6 weeks that radiated to lower back, with no fever, chills or weight loss. He denied smoking cigarettes, alcohol use or any illicit drug. On investigation, a mass was identified on the posterior medial aspect of the right lower lobe with direct infiltration into right side of the T5–T6 vertebral bodies. Histopathology identified organising pneumonia with abscess. Tissue cultures showed S. intermedius, and were negative for other microorganisms. This case highlights a rare presentation of S. intermedius discitis by contiguous spread of infection from posterior right lower lobe lung abscess. S. intermedius usually occurs in older patients with pulmonary infections complicated with pleural effusion or lung abscess, but can present in young patients with no clear symptoms of lung infection, like our patient.

Lung abscess due to Streptococcus intermedius associated with SARS CoV‐2 infection in pregnancy: Unusual presentation and complication of a commensal bacteria during pregnancy

“…Also, it has been described with Haemophilus parainfluenzae as the causative pathogen in a pulmonary abscess in a 75‐year‐old man 14 . Besides, other rare infections in body sites due to S. intermedius have been described, such as a recently described case in which discitis was reported due to contiguous infection due to a lung abscess of the posterior right lower lobe due to S. intermedius 15 . It has also been described as a causative pathogen in Lemierre syndrome in a 21‐year‐old man with S. intermedius bacteremia 16 and in a 29‐year‐old woman who developed multiple lung abscesses secondary to a uterine empyema caused by an intrauterine device with the S. milleri group as the causative agent isolated 17 .…”

Streptococcus intermedius Brain Abscess with Lung Abscess and Aortic Valve Endocarditis: A Case Report and Literature Review

“…We reviewed the available medical literature by PubMed with the keywords “ Streptococcus intermedius ” AND “lung abscess”, “pleural effusion” and “pleural empyema” from 1993 to 2023, published in English. We found 34 articles meeting the inclusion criteria ( Table 2 ), of which 4 described concomitant brain and lung abscesses, but none reported the presence of lung and brain abscesses due to S. intermedius associated with left sided endocarditis [ 1 , 2 , 8 , 9 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Only one paper [ 8 ] described the case of a lung and brain abscess associated with Chiari network endocarditis in the right heart.…”

Pulmonary abscess due to Streptococcus intermedius in pregnancy: unusual presentation and complication of a commensal bacteria during pregnancy

“…Also, it has been described with Haemophilus parainfluenzae as the causative pathogens in a pulmonary abscess in a 75-year-old man 14 . Besides, other rare infections in body sites due to S. intermedius have been described, such as a recently described case in which discitis was reported due to contiguous infection due to a lung abscess of the posterior right lower lobe due to S. intermedius 15 . It has also been described as a causative pathogen in Lemierre syndrome in a 21-year-old man with S. intermedius bacteremia 16 and in a 29-year-old woman who developed multiple lung abscesses secondary to a uterine empyema caused by an intrauterine device with the S. milleri group as the causative agent isolated 17 .…”