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[Actinomycotic brain abscess -case report- (author's transl)]

N Nonaka, K Takamoto, T Marubayashi

No Shinkei Geka. Neurological Surgery

|December 1, 1978

Summary

Central nervous system actinomycosis is rare. A case report details a primary cerebral actinomycosis in an 18-year-old male, originating from a childhood head injury, highlighting diagnostic and treatment considerations.

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Area of Science:

Neurology
Infectious Diseases
Neurosurgery

Background:

Actinomycosis affecting the central nervous system (CNS) is an infrequent clinical occurrence.
The potential for primary CNS actinomycosis, rather than secondary seeding, remains a subject of debate.
Cerebral actinomycosis can present with subtle or delayed neurological symptoms years after initial injury.

Observation:

An 18-year-old male presented with seizure activity 11 years after a penetrating right frontal lobe injury from a wire.
Initial investigations revealed intracranial frontal calcification, followed by advanced imaging (EEG, angiography, RI scan, CT scan).
Surgical exploration identified a granuloma, confirmed histologically as an actinomycotic brain abscess.

Findings:

Histopathological examination confirmed the presence of actinomycosis within the cerebral granuloma.

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The case supports the possibility of primary actinomycosis developing in the brain following penetrating trauma.

Successful treatment involved surgical excision and antibiotic therapy, leading to patient recovery and return to occupation.

Implications:

This case contributes to the understanding of primary cerebral actinomycosis, particularly its association with remote penetrating head trauma.
It underscores the importance of considering actinomycosis in the differential diagnosis of brain abscesses, especially in patients with a history of relevant injury.
The findings emphasize the efficacy of combined surgical and antibiotic management for CNS actinomycosis.