Simultaneous brain and intramedullary spinal abscesses in a patient with Streptococcus intermedius infection

Abstract

• Streptococcus intermedius is a known cause of brain abscesses. • Concurrent disseminated CNS infections in brain and spinal column is rare. • Imaging revealing either spinal or brain abscesses may prompt evaluation of other anatomical sites. A male patient in his thirties presented to the hospital with meningismus and altered mental status. Cerebrospinal fluid (CSF) analysis confirmed meningitis, but no microorganisms were identified. Head imaging (MRI) revealed multiple brain abscesses. Surgically-collected brain specimens revealed Gram-positive cocci and subsequently grew Streptococcus intermedius . MRI of the thoracic spine subsequently also identified an intramedullary spinal abscess. While brain abscesses and spinal abscesses caused by S. intermedius have been previously reported, the extent of disseminated disease in the patient was noteworthy.