Clinical presentation
Patients with infections due to S. intermedius usually present nonspecific symptoms such as fever, chills, and general discomfort among the cases described. However, additionally, patients would exhibit symptoms related to the body side affected by it, for example, seizures, headaches, nausea and vomiting in brain abscesses10,11 or cough, sputum production, shortness of breath, and hemoptysis in pneumonia, empyema, and lung abscesses5,12,13, which are uncommon clinical complications from S. intermedius with few cases currently described (Table 1). Moreover, chest pain, chest distress, and even respiratory failure have been described in pleural effusion and mediastinal abscess due to SAG, besides, odynophagia and cervicodynia in oropharynx infections2.
Also, it has been described with Haemophilus parainfluenzae as the causative pathogens in a pulmonary abscess in a 75-year-old man14. Besides, other rare infections in body sites due to S. intermedius have been described, such as a recently described case in which discitis was reported due to contiguous infection due to a lung abscess of the posterior right lower lobe due to S. intermedius15. It has also been described as a causative pathogen in Lemierre syndrome in a 21-year-old man with S. intermedius bacteremia16 and in a 29-year-old woman who developed multiple lung abscesses secondary to a uterine empyema caused by an intrauterine device with the S. milleri group as the causative agent isolated17. Furthermore, isolated pulmonary nodules and infective endocarditis due to S. intermedius have also been described4,18,19. In our case, blood cultures were performed with a negative result, and no signs or symptoms related to probable or confirmed endocarditis were found. Moreover, a left thoracic artery pseudoaneurysm has been described as a secondary complication of a lung abscess in a 66-year-old man 20.