Abstract
BackgroundStreptococcus intermedius belongs to the Streptococcus anginosus group. It is part of the normal flora of the human mouth, but it can be etiologically associated with deep-site infections.Case presentationWe present a case of deep neck infection complicating Streptococcus intermedius lymphadenitis, which developed in an immunocompetent 14-year-old boy with a history of recent dental work. The infection was ultimately eradicated by a combined medical and surgical approach.ConclusionOur report suggests that combined medical and surgical therapy is essential for the complete resolution of deep infections caused by Streptococcus intermedius. Molecular biological techniques can be useful in guiding the diagnostic investigation and providing insight into the possibility of occult abscesses, which are particularly common with Streptococcus intermedius infections.
Highlights
Streptococcus intermedius belongs to the Streptococcus anginosus group
The identification of the Streptococcus anginosus group (SAG) species based on molecular biological techniques can be useful in guiding the diagnostic investigation and providing insight into the possible role of coinfecting organisms and the probability of occult abscesses, which are more likely with S. intermedius infections [5,6,10,11]
The report describes a case of cervical lymphadenitis complicated by severe deep neck infection caused by S. intermedius in a fully immunocompetent adolescent boy with a history of pharyngotonsillitis and recent orthodontic work
Summary
The report describes a case of cervical lymphadenitis complicated by severe deep neck infection caused by S. intermedius in a fully immunocompetent adolescent boy with a history of pharyngotonsillitis and recent orthodontic work. The initial presentation of these infections can be fairly non-specific and precious time can be lost while more common causes of lymphadenopathy are being excluded. Distinguishing S. intermedius from other SAG species is important because it carries a substantial risk for persistent or recurrent abscesses. Molecular techniques allow rapid and accurate detection of S. intermedius and represent a valuable tool for the management of severe infections caused by this pathogen. Our findings suggest that S. intermedius should be suspected in all cases of deep neck infections in which the patient has recently undergone dental work. Pediatricians should not underestimate the importance of the isolation of this species from clinical specimens
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