Streptococcus intermedius causing brain abscess in a child with acyanotic congenital heart defect

Abstract

Streptococcus intermedius ( S. intermedius ) belongs to the Streptococcus anginosus group (SAG) along with Streptococcus anginosus ( S. anginosus ) and Streptococcus constellatus ( S. constellatus ) . Though all the members of SAG have a propensity to cause deep-seated abscesses at a wide range of sites, when it comes to brain abscesses, it is S. intermedius that is most often implicated. Paediatric population with congenital cyanotic heart disease are especially at risk for developing brain abscess. However, it is a rare occurrence in acyanotic congenital heart diseases. Here, we report a case of frontal brain abscess caused by S. intermedius in a child with a clinically silent atrial septal defect (ASD). However, an echocardiogram revealed a patent foramen ovale (PFO) accompanying the ASD. The child recovered, following burr hole aspiration and 21 days of antibiotic therapy. We report this case to highlight the importance of this pathogen in the aetiology of the brain abscess and due to the rarity of the case.