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Actinomycotic brain abscess
J Benito León1, A Muñoz, P G León
1Servicios de Neurología, Hospital Universitario 12 de Octubre, Madrid.
Abstract:
Actinomycosis is a chronic, suppurative and granulomatous bacterial infection, which tends to form abscesses. Involvement of the central nervous system (CNS) is rare. We describe the clinical and neuroradiological findings of four patients (3 men and one female) diagnosed of actinomycotic brain abscesses. Risk factors were dental pathology, intrauterine device use, alcohol abuse and Rendu-Osler-Weber disease. Clinical manifestations were those of a space-occupying lesion. CT scan findings were varied and little specific: hemispheric or periventricular location, pyocephalus, rim-enhancing and edema. MRI was superior in disclosing pyocephalus. Diagnosis was performed by microbiological and pathological findings. Despite surgery and antibiotics, two of the patients died. In conclusion, the infection of the CNS by Actinomyces is potentially fatal and should be considered in those patients with cerebral abscess.
Insights
Actinomycosis, a rare bacterial infection, can cause brain abscesses in the central nervous system (CNS). Early diagnosis and treatment are crucial as CNS actinomycosis is potentially fatal.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Actinomycosis is a chronic bacterial infection characterized by abscess formation.
- Central nervous system (CNS) involvement is an uncommon but serious manifestation.
Observation:
- This study details four cases of actinomycotic brain abscesses.
- Identified risk factors included dental issues, IUD use, alcohol abuse, and Rendu-Osler-Weber disease.
- Clinical presentation mimicked space-occupying lesions.
Findings:
- CT scans showed non-specific findings like hemispheric/periventricular location, rim enhancement, and edema.
- MRI proved more effective in visualizing pyocephalus.
- Diagnosis relied on microbiological and pathological evidence.
Implications:
- CNS actinomycosis is a potentially fatal condition.
- Cerebral abscesses warrant consideration for Actinomyces infection, especially with identified risk factors.
- Aggressive management involving surgery and antibiotics is necessary, though outcomes can be poor.