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Case Reports
. 2021 Jul 22;34(6):698-700.
doi: 10.1080/08998280.2021.1945354. eCollection 2021.

Actinomyces causing a brain abscess

Alejandro Perez  1 , Gaurav Syngal  2 , Samreen Fathima  3 , Uriel Sandkovsky  4
Affiliations
Case Reports

Actinomyces causing a brain abscess

Alejandro Perez et al. Proc (Bayl Univ Med Cent). .

Abstract

Actinomycosis is an uncommon, chronic granulomatous disease caused by the filamentous, gram-positive bacterium Actinomyces israelii. It causes indolent, painful wound infections commonly presenting with oral-cervicofacial manifestations, but other infections of the chest wall and gastrointestinal and genital tract are also seen. A high level of suspicion is required for diagnosis, as it may be missed or mistaken for malignancy. Severe cases may involve the central nervous system and require surgical intervention. We present a case report of actinomycosis causing a brain abscess.

Keywords: Actinomyces; actinomycosis; brain abscess; central nervous system.

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Figures

Figure 1.
Figure 1.
Brain imaging. (a) CT without contrast showing a 3.5 × 2.1 cm peripherally hyperdense mass within the left frontal lobe with extensive associated vasogenic edema and a 10 mm left-to-right subfalcine herniation. (b) Diffusion-weighted and (c) T2-weighted MRI showing a 3.5 × 2.4 cm mass within the left frontal lobe compatible with a cerebral abscess. The vasogenic edema involves the left frontal lobe and anterior parietal lobe with diffuse sulcal effacement and left-to-right midline shift. (d) Diffusion-weighted and (e) T2-weighted MRI showing interval improvement in the left frontal lobe abscess cavity with decreased surrounding edema and improvement in the mass effect without midline shift.
Figure 2.
Figure 2.
(a) Hematoxylin and eosin–stained slide showing a cluster of filamentous-appearing bacteria. (b) Grocott’s methenamine silver–stained slide highlighting the filamentous appearance of Actinomycetes.
Figure 3.
Figure 3.
(a) CT of the chest without contrast showing irregular small areas of nodular consolidation within the right upper lobe as well as within the right lower lobe superior segment. Irregular reticulonodular opacities are scattered throughout. A partially cavitary nodule is present in the left upper lobe apex measuring 8 mm in greatest dimension, and a small right pleural effusion is present. (b) Near resolution of right upper and lower lobe infiltrates and of right pleural effusion, with resolution of the left lung nodule and no evidence of a cavitary lesion.
See this image and copyright information in PMC

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