A Rare Case of Slowly Progressive Meningitis Caused by Streptococcus intermedius.
Yuri Kawano, Toshitaka Kamon, Rika Hagihara et al.
✦ AI-curated · Sources linked
Case in brief
An elderly patient with cancer developed meningitis due to Streptococcus intermedius, with an unusually gradual, subacute-to-chronic course. Blood cultures confirmed S. intermedius bacteremia, but cerebrospinal fluid cultures were negative. Although this infection commonly involves intracranial suppuration, systemic imaging showed no abscesses or other infectious foci. Cerebrospinal fluid 16S rRNA gene analysis identified S. intermedius, establishing the diagnosis despite negative cultures.
What made this case unusual
The meningitis progressed unusually slowly and occurred without the abscesses or other infectious foci often associated with S. intermedius infection.
Diagnostic / clinical pearl
When S. intermedius meningitis is suspected but cerebrospinal fluid cultures are negative, 16S rRNA gene analysis of cerebrospinal fluid may identify the pathogen.