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Brain abscess caused by Streptococcus intermedius: two case reports.
M Yamamoto1, T Fukushima, S Ohshiro
1Department of Neurosurgery, Fukuoka University School of Medicine, Japan.
Surgical Neurology
|February 24, 1999
Summary
Streptococcus intermedius is an emerging cause of brain abscess, often linked to sinusitis. Prompt diagnosis and treatment with antibiotics and aspiration lead to good outcomes in patients with S. intermedius brain abscess.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Streptococcus intermedius, part of the Streptococcus milleri group, is a known pathogen for abscesses.
- The Streptococcus milleri group is often overlooked as a cause of brain abscess, with Streptococcus viridans being the commonly suspected pathogen.
Observation:
- Two cases of left frontal lobe brain abscess caused by Streptococcus intermedius are presented.
- Predisposing factors included paranasal sinusitis in one patient; the source was undetected in the other.
- Both patients were successfully treated with antimicrobial therapy and needle aspiration (ultrasound-guided or CT-guided stereotactic).
Findings:
- Streptococcus intermedius was successfully identified as the causative agent in both brain abscess cases.
- Effective treatment involved a combination of antimicrobial therapy and surgical aspiration.
- Patients recovered without neurological deficits, highlighting the treatability of these infections.
Implications:
- Clinicians should consider Streptococcus intermedius as a potential pathogen in brain abscess cases.
- Recognizing predisposing factors like mucosal disturbances and liver abscesses is crucial for early diagnosis.
- This study underscores the importance of accurate pathogen identification and tailored treatment for brain abscess management.