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A Report of Two Cases of Meningoencephalitis Caused by Streptococcus intermedius

Jun-Li Pan1, Wen-Jun Wu1, Shu-Yan Zeng2

  • 1Department of Neurology, Zhongshan City People's Hospital, Zhongshan, Guangdong province, 528403, People's Republic of China.

Infection and Drug Resistance
|June 5, 2024
PubMed
Abstract

Insights

Meningoencephalitis caused by Streptococcus intermedius is complex, often forming multiple cerebral abscesses. Genome sequencing aids diagnosis, and prompt treatment with potent antibiotics improves outcomes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Meningoencephalitis presents a diagnostic challenge, particularly when caused by less common pathogens.
  • Streptococcus intermedius, a member of the viridans group streptococci, can cause severe central nervous system infections.

Observation:

  • Two patients with Streptococcus intermedius meningoencephalitis presented with neurological decline and multiple cerebral abscesses.
  • Initial cultures were negative, highlighting limitations in standard diagnostic methods.
  • Genome sequencing of cerebrospinal fluid identified Streptococcus intermedius as the causative agent.

Findings:

  • Patients initially responded to meropenem but deteriorated, necessitating a change in treatment.
  • Combination therapy including linezolid led to clinical improvement and abscess resolution.
  • The disease course was characterized by an improvement-deterioration-improvement pattern.

Implications:

  • Genome sequencing is a valuable tool for diagnosing challenging meningoencephalitis cases.
  • Early etiological identification and potent antibiotic therapy are crucial for managing Streptococcus intermedius meningoencephalitis.
  • Understanding the complex clinical course and potential for multiple cerebral abscesses is vital for effective patient management.
Keywords:
Genome sequencingmeningoencephalitismultiple cerebral abscesses Streptococcus intermedius

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