Abstract
BACKGROUND: Pediatric basal ganglia abscesses are extremely rare, with only 2 other published cases in the literature. To the authors' knowledge, this is the first case of a primary bacterial abscess caused by Streptococcus intermedius in the basal ganglia of a pediatric patient. OBSERVATIONS: This case coincides with a rise in neuroinvasive streptococcal infections among children during the COVID-19 pandemic. Prompt MRI with diffusion and attenuation analyses allowed for abscess identification and treatment with neurosurgical drainage, leading to full recovery. Although intracranial abscesses in deep parenchymal locations are extremely rare in healthy children, the recently increased incidence of neuroinvasive infections and the devastating sequelae of delayed or missed diagnosis make early recognition and treatment essential. To this end, reporting and recognition of the varied presentations of this pathology is crucial. LESSONS: Herein, the authors highlight that in light of the surge in cases in recent years, patients suspected of having an intracranial abscess should not be delayed in receiving cranial imaging and treatment, as rapid identification and management of abscesses are crucial to reduce the likelihood of long-term complications. https://thejns.org/doi/10.3171/CASE24562.