{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T13:03:11Z","timestamp":1781701391920,"version":"3.54.5"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Community-acquired pneumonia (CAP) is a leading cause of hospitalization and mortality, with\n                    <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                    as a leading cause. Chest radiography, the standard initial imaging modality, can miss early complications, which lead to delays in diagnosis and treatment. Computed tomography (CT) provides greater detail in identifying complications. We report a 67-year-old male with chest pain who was treated in an outpatient setting with oral antibiotics for suspected CAP; however, he experienced clinical deterioration, including fever, cough, weight loss, and worsening respiratory symptoms. Repeat chest X-ray revealed increased lung opacities, prompting a CT thorax, which revealed a large pulmonary abscess not visualized on prior imaging. Failure of outpatient management required inpatient admission with intravenous antibiotics and CT-guided percutaneous drainage. A total of 450\u2009mL of purulent fluid was drained, and cultures grew\n                    <jats:italic toggle=\"yes\">Streptococcus intermedius<\/jats:italic>\n                    . The patient improved and was given targeted antibiotics. This case highlights the importance of considering less common pathogens such as\n                    <jats:italic toggle=\"yes\">S. intermedius<\/jats:italic>\n                    in patients with prolonged symptoms or failure of outpatient therapy. CT imaging should be considered in patients who fail to improve, thus expediting diagnosis and guiding management.\n                    <jats:italic toggle=\"yes\">S. pneumoniae<\/jats:italic>\n                    typically causes acute pneumonia with lobar consolidation.\n                    <jats:italic toggle=\"yes\">S. intermedius<\/jats:italic>\n                    often causes necrotizing abscesses and empyema, often with a longer, more subacute presentation. Differentiating the two on initial presentation is quite difficult, as in our patient\u2019s case.\n                  <\/jats:p>","DOI":"10.1177\/2050313x261456973","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:20:16Z","timestamp":1781522416000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment failure in suspected community-acquired pneumonia revealing a pulmonary abscess"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5625-290X","authenticated-orcid":false,"given":"Sindhuja","family":"Earagolla","sequence":"first","affiliation":[{"name":"John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Karnath","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sravya","family":"Borra","sequence":"additional","affiliation":[{"name":"Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Karnath","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"897","article-title":"Complication of community-acquired pneumonia (Including cardiac complications)","volume":"6","author":"Restrepo MI","year":"2016","unstructured":"Restrepo MI, Reyes LF, Anzueto A. Complication of community-acquired pneumonia (Including cardiac complications). Semin Respir Crit Care Med 2016; 6: 897\u2013904.","journal-title":"Semin Respir Crit Care Med"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.10.039"},{"key":"e_1_3_2_4_2","article-title":"Chest computed tomography and chest X-ray in the diagnosis of community-acquired pneumonia: a retrospective observational study","volume":"8","author":"Ibrahim D","year":"2021","unstructured":"Ibrahim D, Bizri AR, El Amine MA, et al. Chest computed tomography and chest X-ray in the diagnosis of community-acquired pneumonia: a retrospective observational study. J Int Med Res 2021; 8: 3000605211039791.","journal-title":"J Int Med Res"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.21276\/apjhs.2016.3.4S.3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-228849"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.07.035"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201501-0017OC"},{"key":"e_1_3_2_9_2","article-title":"Empyema versus lung abscess: a case report","volume":"10","author":"Imburgio S","year":"2022","unstructured":"Imburgio S, Tavakolian K, Mararenko A, et al. Empyema versus lung abscess: a case report. J Investig Med High Impact Case Rep 2022; 10: 23247096221139268.","journal-title":"J Investig Med High Impact Case Rep"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2018-211604"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8040514"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20082004"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaf538"},{"issue":"12","key":"e_1_3_2_14_2","article-title":"Pleural space infection microbiology as assessed using a clinical sequencing-based assay: fusobacterium nucleatum group, Streptococcus intermedius, and other oral normal microbiota are the most common bacteria identified in community-acquired pleural space infections","volume":"62","author":"Otero JA","year":"2024","unstructured":"Otero JA, Mandrekar J, Wolf MJ, et al. Pleural space infection microbiology as assessed using a clinical sequencing-based assay: fusobacterium nucleatum group, Streptococcus intermedius, and other oral normal microbiota are the most common bacteria identified in community-acquired pleural space infections. J Clin Microbiol 2024; 62(12): e00694.","journal-title":"J Clin Microbiol"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000447976"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.07.465"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.08.48"},{"issue":"2","key":"e_1_3_2_18_2","article-title":"Utility of the New Early Warning Score (NEWS) in combination with the neutrophil-lymphocyte ratio for the prediction of prognosis in older patients with pneumonia","volume":"11","author":"Kakehi E","year":"2023","unstructured":"Kakehi E, Uehira R, Ohara N, et al. Utility of the New Early Warning Score (NEWS) in combination with the neutrophil-lymphocyte ratio for the prediction of prognosis in older patients with pneumonia. Fam Med Community Health 2023; 11(2): e002239.","journal-title":"Fam Med Community Health"}],"container-title":["Sage Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X261456973","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X261456973","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X261456973","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:22:09Z","timestamp":1781698929000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X261456973"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":17,"alternative-id":["10.1177\/2050313X261456973"],"URL":"https:\/\/doi.org\/10.1177\/2050313x261456973","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"value":"2050-313X","type":"print"},{"value":"2050-313X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"2050313X261456973"}}