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Cureus Aug 2023Actinomycosis is a chronic, indolent, granulomatous disease process caused by the genus of bacteria. More severe forms of actinomycosis include disseminated or central...
Actinomycosis is a chronic, indolent, granulomatous disease process caused by the genus of bacteria. More severe forms of actinomycosis include disseminated or central nervous system (CNS) infections. is the most common species of isolated from brain abscesses. species is commonly associated with skin and soft tissue abscesses. However, it rarely causes brain abscesses. We present an unusual case of brain abscess in a 69-year-old female who presented with acute encephalopathy and bilateral lower extremity weakness. She was diagnosed with left-sided mastoiditis with intracranial extension, left posterior fossa epidural abscess, and transverse sinus thrombosis. The patient's hospital course was complicated by hydrocephalus and declining neurological status. Empiric antimicrobial therapy was initiated, and the patient underwent mastoidectomy and external ventricular drain placement followed by decompression craniotomy and subarachnoid abscess aspiration. Given her poor and unchanged neurologic status, the patient was transitioned to comfort-oriented measures after shared decision-making with the family. It is crucial to identify as a causal agent of severe CNS infections like brain abscesses, meningoencephalitis, or subdural empyema, as untreated infections can lead to irreversible neurologic complications.
PubMed: 37664255
DOI: 10.7759/cureus.42868 -
Revista Argentina de Microbiologia 2023A brain abscess is a focal infection characterized by a collection of pus in the brain parenchyma. It is a life-threatening condition that should be diagnosed and...
A brain abscess is a focal infection characterized by a collection of pus in the brain parenchyma. It is a life-threatening condition that should be diagnosed and treated as soon as possible. We report here three cases of patients with otogenic brain abscesses of polymicrobial origin that had in common the isolation of Actinomyces europaeus, which has not been previously described in this location. A. europaeus was identified by the conventional methodology, matrix-associated laser deionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. Antibiotic susceptibility was evaluated by the epsilometric method, and all isolates showed sensitivity to penicillin, vancomycin and linezolid, whereas susceptibility to clindamycin and erythromycin was variable. MALDI-TOF MS identification allowed a quick and reliable species level identification in order to provide a rapid and effective response to avoid treatment delay that could lead to increased morbidity and even mortality.
Topics: Humans; RNA, Ribosomal, 16S; Actinomyces; Brain Abscess; Clindamycin; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
PubMed: 36642684
DOI: 10.1016/j.ram.2022.07.003