Streptococcus intermedius Pleuropulmonary Disease: A Not So Commonly Seen Radiological Picture

Abstract

A Streptococcus ( S. ) intermedius- associated pleuropulmonary infection (PPI) is a rare presentation. Cases have been reported in the last decade in which S. intermedius was identified in pleural fluid cultures and lung biopsies in patients presenting with complicated pleural effusions and empyema. However, there are data lacking on predisposing factors, mode of dissemination, and treatment strategies for these patients. Moreover, these patients can present with a spectrum of radiographic findings, which can help with prompt diagnosis and effective patient management. However, the radiological findings in this patient and the rapidly worsening clinical symptoms make the diagnosis difficult.

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

“…With respect to the route of infection, the airway was the main route of dissemination for the infection in our case, and despite the fact that certain risk factors such as smoking, alcoholism, dental diseases, chronic obstructive pulmonary disease, malignant neoplasms, liver cirrhosis, and diabetes have been described, 1 in our case, none of these risk factors were present.…”

“…Streptococcus intermedius is a catalase‐negative, gram‐positive cocci, whose most isolates are nonhemolytic with small colony‐forming species, which belongs to the Streptococcus anginosus group (SAG), which has also been referred to as the Streptococcus milleri group, which includes 3 organisms: S. anginous , S. intermedius , and S. constellatus . 1 This bacterial group has not been recognized as a causative pathogen. However, with the presence of certain factors, SAG could induce noninvasive infections and also invasive infections after getting into sterile body sites, such as the blood and serosal cavity, which is why it could affect the tissues and organs of several systems of the body.…”

“… 1 , 5 Among the risk factors for these infections, smoking, alcoholism, dental diseases, chronic obstructive pulmonary disease, malignant neoplasms, liver cirrhosis, and diabetes have been described. 1 Through this case report with a literature review, we discuss an acute presentation of S. intermedius lung abscess in a pregnant woman with radiological findings that make it difficult to distinguish it as a lung neoplasm, empyema, or abscess.…”

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

“…Streptococcus (S.) intermedius is a catalase-negative, gram-positive cocci, whose most isolates are nonhemolytic with small-colony-forming species, which belongs to the Streptococcus anginosus group (SAG), which has also been referred to as the Streptococcus milleri group, which includes 3 organisms: S. anginous, S. intermedius, and S. constellatus 1 . This bacterial group has not been recognised as a causative pathogen.…”

“…S. intermedius is part of the commensal oral flora in humans, and it is frequently associated with brain and liver abscesses, but less frequently with pleuropulmonary infections including pneumonia, pleural effusion, and empyema, and in a few cases, it can also be the causal agent of lung abscesses. 1,5 . Among the risk factors for these infections, smoking, alcoholism, dental diseases, chronic obstructive pulmonary disease, malignant neoplasms, liver cirrhosis, and diabetes have been described 1 .…”