Article in Japanese

A pediatric case of cervical lymph node abscess due to Streptococcus intermedius

Yasuhiro HANEDA^1）, Akiyoshi NaRIAI^1,2）

A 10-year-old girl visited our hospital due to swelling and pain in the left parotid gland that had occurred 10 days prior. She was prescribed cefcapene pivoxil and amoxicillin but showed no improvement. She was then referred to the pediatric department
and was admitted. Her left parotid gland showed redness, swelling, and induration of 3-4 cm in size, and the mouth opening was restricted. Ultrasonography showed a low echo region (15.9 ×10.4 mm) in the right parotid gland. Based on the above findings, we diagnosed a lymph node abscess in the left parotid gland, and the abscess drainage was performed by an otolaryngologist. Streptococcus intermedius and the anaerobic Prevotella bivia were identified. We administered ampicillin and clindamycin intravenously. After the definition of drug susceptibility, we switched to oral administration of tevipenem pivoxil for 12 days, and the treatment was terminated. Since then, there has been no recurrence have been observed. The incidence of pyogenic disease caused by S. intermedius
is increasing in United States. Also in Japan, the epidemic of pediatric bacterial infections changed drastically after the introduction of two pivotal vaccines (pneumococcal vaccine and influenza b type vaccine). Therefore, it is necessary to recall that there is a coexistence between S. intermedius and anaerobic bacteria when faced with an abscess in children.

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1）Division of Pediatrics, Matsue Red Cross Hospital

2）Division of Infectious Diseases, Matsue Red Cross Hospital

Key words	Streptococcus intermedius，Streptococcus anginosus group, cervical lymph node abscess
Received	July 17, 2021
Accepted	November 17, 2021

33 (4)：387─392,2021