Rare case of pyogenic brain abscess in a immunocompetent children caused by Streptococcus intermedius

Background: Brain abscess is rare but life-threatening infection in children. It caused by parameningeal infections like otitis, sinusitis and mastoiditis. Case description A twelve-year-old boy without any antecedent was admitted to the emergency room with complaints of palpebral tumefaction increased after treatment of ethmoiditis. A cranial computed tomography (CT) examination showed an intra-orbital abscess 23 x 17mm with intracranial extension. The patient underwent surgery to drain abscess. A microbiological sample was sent to the laboratory and empirical antibiotic treatment with ceftriaxone, gentamicin and metronidazol were started. The therapy was continued for four weeks. Postoperative cranial CT examination showed a resolution of the abscess. The child was discharged without any sequelae. Discussion This risk is much more present in children with immunodepressed state and congenital heart disease. Streptococcus intermidius is commonly found in oral, oropharyngeal, or gastrointestinal flora, which can cause brain abscess rarely in children. Brain abscess still induce a mortality relatively high, even if advancement of imaging techniques, the association between surgical drainage and antimicrobial therapy. Conclusion Our case is one of the few reported cases of brain abscess caused by S. intermedius in an immunocompetent child. The rapid management of this case at diagnostic and therapeutic made it possible to heal completely the child and change the outcome.