Navigating a stealthy invader: Insights from two different Streptococcus intermedius cases.

Streptococcus intermedius, a gram-positive, beta-hemolytic, catalase-negative member of the Streptococcus milleri group, is a commensal organism within the human body that is known for its propensity to cause severe bacterial infections. This case report presents two distinct cases involving culture-positive S. intermedius infections. The first case involves a 53-year-old man diagnosed with new liver, lung, and brain lesions in the setting of suspected renal cell carcinoma. In the second case, an 84-year-old woman was found to have S. intermedius bacteremia with concurrent culture-positive liver abscesses. These cases illustrate the intricate nature of S. intermedius infections, which may manifest with a diverse spectrum of clinically significant systemic symptoms. Presently, there are no standardized protocols for screening, and subsequently managing, S. intermedius infections. Since S. intermedius has the potential to mimic other infections or pathological conditions, it warrants space on a differential until a negative culture or PCR assay is obtained.