A previously healthy 27-year-old man presented with headaches, fever, and confusion, leading to the discovery of multiple brain abscesses. Initial cultures were negative, but 16S rRNA gene sequencing of aspirate from a frontal lobe abscess identified Streptococcus intermedius. The patient underwent surgical drainage and received prolonged antibiotic therapy, resulting in resolution of the abscesses and clinical improvement. This case highlights the importance of advanced molecular diagnostics, like 16S rRNA gene sequencing, for identifying fastidious or culture-negative organisms in severe infections, especially in immunocompetent individuals with unusual presentations.
Key note: 16S rRNA gene sequencing is crucial for diagnosing culture-negative central nervous system infections.