Cervical spinal cord compression in a child with cervicofacial actinomycosis
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Po-Cheng Hung1, Huei-Shyong Wang1, Cheng-Hsun Chiu2
1Division of Pediatric Neurology, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan, ROC.
Abstract:
Actinomycosis is a rare, chronic, suppurative, and slowly progressive granulomatous disease caused by a group of filamentous gram-positive anaerobic bacteria belonging to the normal flora of the oral cavity, gastrointestinal, and genitourinary tracts. It may involve several organs; however, spinal cord compression has rarely been reported. We report a 7-year-3-month-old girl who suffered from neck pain with restricted movement, poor appetite, body weight loss, mild right limbs weakness, and a non-tender neck mass. Histopathology of the neck mass revealed sulfur granules of actinomyces. Since actinomycosis was strongly suspected, she was treated with high dose of parenteral penicillin G followed by oral penicillin with complete recovery. The unusual features of our case suggested that actinomycosis should be considered as a differential diagnosis of neck mass and cervical spinal cord compression.
Insights
Actinomycosis, a rare bacterial infection, can cause neck masses and spinal cord compression. Early diagnosis and penicillin treatment led to a full recovery in a pediatric case.
Area of Science:
- Microbiology
- Infectious Diseases
- Neurology
Background:
- Actinomycosis is a rare, chronic bacterial infection caused by filamentous gram-positive anaerobic bacteria.
- While it can affect various organs, spinal cord compression is an infrequent manifestation.
- These bacteria are part of the normal flora in the oral cavity, gastrointestinal, and genitourinary tracts.
Observation:
- A 7-year-old girl presented with neck pain, limited movement, appetite loss, weight loss, and mild right limb weakness.
- A non-tender neck mass was discovered, and histopathology revealed characteristic sulfur granules of actinomyces.
- The clinical presentation suggested cervical spinal cord compression.
Findings:
- Histopathological examination confirmed actinomycosis by identifying sulfur granules.
- Prompt treatment with high-dose parenteral penicillin G, followed by oral penicillin, resulted in complete recovery.
- This case highlights the successful management of a rare presentation of actinomycosis.
Implications:
- Actinomycosis should be considered in the differential diagnosis of neck masses, especially in pediatric patients.
- Cervical spinal cord compression, though rare, can be a complication of actinomycosis.
- Early recognition and appropriate antibiotic therapy are crucial for favorable outcomes in actinomycosis cases.
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