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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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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.

Frontiers in Neurology
|July 28, 2020
PubMed
Summary

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.

Keywords:
actinomycosiscompressionhistopathologyintraspinal infectionnerve roots

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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.