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Botryomycosis: first report of human brain involvement
Southern Medical Journal
|December 1, 1978
Summary
A rare brain abscess, initially mistaken for actinomycosis, was successfully treated. This case highlights alpha-hemolytic streptococcus as a cause of bacterial brain abscesses, often linked to dental infections.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Brain abscesses are serious infections requiring prompt diagnosis and treatment.
- Distinguishing bacterial abscesses from fungal or other granulomatous diseases can be challenging.
- Dental infections are a known, though less common, source of brain abscesses.
Observation:
- A 57-year-old man presented with sudden-onset, right-sided motor seizures.
- Cerebral imaging revealed an avascular left frontal lobe mass.
- Surgical excision identified the mass as a brain abscess.
Findings:
- Histological examination showed granules resembling actinomycosis but revealed gram-positive cocci in chains.
- Cultures from the abscess yielded alpha-hemolytic streptococcus in pure culture.
- Subsequent dental evaluation identified periodontal abscesses, with cultures positive for alpha-hemolytic streptococcus and Staphylococcus aureus.
Implications:
- This case highlights a rare bacterial etiology of brain abscess that mimics fungal infections like actinomycosis.
- Prompt identification and treatment of dental infections are crucial to prevent serious complications such as brain abscess.
- The findings underscore the importance of considering bacterial causes, particularly streptococcal species, in brain abscesses with atypical histological features.