Spinal Intrathecal Actinomycosis Causes Multisegmental Root Failure: A Case Report
Yanying Wang1, Xinyu Ren2, Dongchao Shen1
1Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Abstract:
Actinomycosis is a slowly progressing infection caused by Actinomyces species, which consists of filamentous gram-positive bacteria. Intraspinal actinomycosis is very rare and most of the previous cases presented with epidural lesions. Only two cases of intrathecal actinomycosis have been described. We reported a case of intrathecal actinomycosis in a 46-year-old woman. Our patient presented with multisegmental root failure, which was different from previous intrathecal cases mainly involving the spinal cord. The manifestations, cervical MR imaging results, biopsy and histopathological features, and treatment history of the patient were reviewed. Clinical features of this disease resemble intraspinal neoplasms, other infectious processes, and granulomatous diseases, thus being difficult to diagnose preoperatively. Histopathological evidence from the biopsy is important for timely diagnosis. Early diagnosis and treatment may greatly improve the prognosis.
Insights
Intraspinal actinomycosis, a rare infection by Actinomyces bacteria, can present unusually with nerve root failure. Prompt diagnosis via biopsy and early treatment are crucial for better outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Actinomycosis is a rare, slow-progressing infection caused by filamentous gram-positive Actinomyces bacteria.
- Intraspinal actinomycosis is exceptionally rare, with most prior cases involving epidural lesions.
- Only two cases of intrathecal actinomycosis have been previously documented.
Observation:
- This report details a unique case of intrathecal actinomycosis in a 46-year-old woman.
- The patient exhibited multisegmental nerve root failure, a presentation distinct from previously reported intrathecal cases.
- Clinical manifestations mimicked intraspinal neoplasms, other infections, and granulomatous diseases, complicating preoperative diagnosis.
Findings:
- Cervical MRI results, biopsy, and histopathological findings were reviewed.
- Histopathological evidence from biopsy is critical for accurate and timely diagnosis.
- The patient's treatment history was analyzed in the context of the rare condition.
Implications:
- Early diagnosis of intraspinal actinomycosis is essential for effective management.
- Prompt treatment can significantly improve patient prognosis.
- This case expands the understanding of intrathecal actinomycosis presentations and diagnostic challenges.
