Citation Information :
John SH, Amma R, Jayaprakash C, George S. Streptococcus intermedius causing brain abscess in a child with acyanotic congenital heart defect. 2015; 17 (2):124-126.
Streptococcus intermedius (S. intermedius) belongs to the Streptococcus anginosus group (SAG) along with Streptococcus anginosus (S. anginosus) and Streptococcus constellatus (S. constellatus). Though all the members of SAG have a propensity to cause deep-seated abscesses at a wide range of sites, when it comes to brain abscesses, it is S. intermedius that is most often implicated. Paediatric population with congenital cyanotic heart disease are especially at risk for developing brain abscess. However, it is a rare occurrence in acyanotic congenital heart diseases. Here, we report a case of frontal brain abscess caused by S. intermedius in a child with a clinically silent atrial septal defect (ASD). However, an echocardiogram revealed a patent foramen ovale (PFO) accompanying the ASD. The child recovered, following burr hole aspiration and 21 days of antibiotic therapy. We report this case to highlight the importance of this pathogen in the aetiology of the brain abscess and due to the rarity of the case.
Tran MP, Caldwell-McMillan M, Khalife W, Young VB. Streptococcus intermedius causing infective endocarditis and abscesses: A report of three cases and review of the literature. BMC Infect Dis 2008;8:154.
Winn WC, Allen SD, Janda WM, Koneman EW, Procop GW, Schreckenberger PC, et al. Gram-Positive Cocci. Part 2. In: Darcy P, Peterson N, Montalbano J, editors. Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 695-7.
Mishra AK, Fournier PE. The role of Streptococcus intermedius in brain abscess. Eur J Clin Microbiol Infect Dis 2013;32:477-83.
Junckerstorff RK, Robinson JO, Murray RJ. Invasive Streptococcus anginosus group infection-does the species predict the outcome? Int J Infect Dis 2014;18:38-40.
Clarridge JE 3rd, Attorri S, Musher DM, Hebert J, Dunbar S. Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (“Streptococcus milleri group”) are of different clinical importance and are not equally associated with abscess. Clin Infect Dis 2001;32:1511-5.
Petti CA, Simmon KE, Bender J, Blaschke A, Webster KA, Conneely MF, et al. Culture-Negative intracerebral abscesses in children and adolescents from Streptococcus anginosus group infection: A case series. Clin Infect Dis 2008; 46:1578-80.
Gupta PK, Marzook RA, Sulaibeekh L. Multiple intracranial abscesses: Heralding asymptomatic venosus ASD. Asian J Neurosurg 2013;8:202-5.
Jan F, Hafiz AM, Gupta S, Meidl J, Allaqaband S. Brain abscesses in a patient with a patent foramen ovale: A case report. J Med Case Rep 2009;3:9299.