Key clinical message:
S. intermedius has a unique tropism in the brain, liver, and lungs
leading to abscess formation. When compared to other members of this
group like Streptococcus anginosus and Streptococcus constellatus, S.
intermedius infections are more substantial. S. intermedius is unique to
the other bacteria in SAG due to the expression of intermedilysin (ILY),
allowing it to cause cell necrosis with membrane bleb formation. The
mortality rate for SAG-associated bacteremia is 10-16%. Early
recognition and timely intervention are important for successful
treatment and improved outcomes. There are currently no screening
guidelines when S. intermedius is found in culture data however
clinicians should have a low threshold to consider imaging for indolent
infections.