Streptococcus intermedius lung abscess in children: a case report and literature review

Streptococcus intermedius is a gram-positive commensal associated with suppurative infections. Pediatric pulmonary abscesses due to S. intermedius are rare, and outcomes in children with severe neurological comorbidities are poorly characterized. A 5-year-old boy with refractory epilepsy and global developmental delay who presented with a right upper lobe abscess, pneumonitis, and pleural effusion. Targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF), drainage pus culture, and tNGS of drainage pus all confirmed the presence of S. intermedius . To our knowledge, this is the first reported case of a residual pulmonary cavity on 3-month follow-up imaging after an S. intermedius lung abscess in a child with severe neurological impairment. Our findings highlight the value of tNGS in diagnosing lower respiratory tract infections caused by pathogens that are difficult to identify through conventional culture methods.