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Multiple actinomyces brain abscesses: case report.

M S Tsai1, J J Tarn, K S Liu

  • 1Institute of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|March 13, 2001
PubMed
Summary
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A rare case of multiple brain abscesses caused by actinomyces in a lung cancer patient was successfully treated. Prompt antibiotic therapy, surgery, and long-term monitoring led to a full recovery.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Oncology

Background:

  • Cerebral actinomycosis is a rare infection, often presenting with non-specific symptoms.
  • Mucoepidermoid carcinoma of the lung can be a potential source for disseminated actinomycosis.
  • Effective management requires a multidisciplinary approach involving neurosurgery, infectious disease, and oncology.

Observation:

  • A 37-year-old male with known mucoepidermoid carcinoma of the right lung presented with multiple cerebral abscesses.
  • Actinomyces bacteria were identified in the abscess material, presumed to have originated from the lung.
  • The patient underwent stereotactic surgery for abscess aspiration under computed tomography (CT) guidance.

Findings:

  • Combined therapy included intravenous antibiotics (penicillin, sulfonamide, erythromycin) and surgical aspiration.

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  • Intracranial pressure management was a critical component of the treatment strategy.
  • Long-term follow-up with frequent computerized tomography (CT) evaluations was performed.

    • Implications:

    • This case highlights the importance of considering actinomycosis in immunocompromised patients with lung cancer and neurological symptoms.
    • Aggressive treatment combining antibiotics and surgical intervention can lead to successful outcomes in cerebral actinomycosis.
    • Early diagnosis and comprehensive management are crucial for preventing severe neurological deficits and ensuring patient recovery.