Atypical Presentation of a Cerebellar Abscess Caused by Streptococcus intermedius: Importance of Early Recognition

A cerebellar abscess due to <i>Streptococcus intermedius</i> is an uncommon clinical entity that may present with features resembling a neoplastic lesion, making early recognition challenging. <i>S. intermedius,</i> a member of the <i>Streptococcus anginosus</i> group, has a marked ability to induce tissue destruction and trigger a pronounced inflammatory response, ultimately leading to the formation of purulent collections with peripheral enhancement on neuroimaging. Although gram-positive cocci are recognized causes of brain abscesses, involvement of the cerebellum by this organism is rare. Awareness of this atypical clinical presentation is critical, since its pseudotumoral behavior may obscure the underlying infectious etiology and delay appropriate therapy. Integrating clinical manifestations, radiological characteristics, and microbiological confirmation is therefore essential for timely diagnosis and favorable clinical outcomes.