Unusual Localization of Rothia kristinae Infection: First Report of an Intracerebral Abscess in a Pediatric Patient

Introduction: This case describes a rare pediatric intracerebral infection caused by Rothia kristinae, an uncommon pathogen not typically associated with brain abscesses. Its novelty lies in the unexpected etiology and clinical evolution, underscoring diagnostic and therapeutic challenges in resource-limited settings. Case: A 9-year-old girl presented with persistent headache, vomiting, visual disturbances, and bradycardia. Neurological imaging revealed a posterior fossa lesion. Neurosurgical intervention was performed to drain the lesion, and microbiological analysis confirmed Rothia kristinae from abscess culture. Empirical antibiotic therapy with ceftriaxone, vancomycin, and metronidazole was initiated. Surgical drainage and antimicrobial treatment led to clinical improvement. The patient developed post-treatment thrombocytopenia, managed with corticosteroids, with full resolution of symptoms. Conclusions: This case highlights the importance of considering atypical pathogens in pediatric neuroinfections and demonstrates the effectiveness of early surgical and antimicrobial management.