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Extensive actinomycosis with intracranial and mediastinal involvement: a therapeutic challenge

Central nervous system (CNS) involvement by actinomycosis is rare, seen in 2%–3% cases. It mostly spreads to CNS by haematogenous route from a distant primary site such as oral cavity, lung, abdomen or pelvis. Direct CNS extension can also occur. It mostly presents as brain abscess, meningoencephali...

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Detalles Bibliográficos
Autores principales: Ansari, Farzana, Budania, Anil, Rao, Meenakshi, Yadav, Taruna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9394199/
https://www.ncbi.nlm.nih.gov/pubmed/35981749
http://dx.doi.org/10.1136/bcr-2021-247694
Descripción
Sumario:Central nervous system (CNS) involvement by actinomycosis is rare, seen in 2%–3% cases. It mostly spreads to CNS by haematogenous route from a distant primary site such as oral cavity, lung, abdomen or pelvis. Direct CNS extension can also occur. It mostly presents as brain abscess, meningoencephalitis, actinomycetoma, subdural empyema and epidural abscess. We report one case of extensive actinomycosis having intra and extraparenchymal CNS, spinal canal, retropharyngeal and mediastinal involvement. Due to such widespread extension and involvement of vital areas, complete surgical debulking was not possible. In addition to therapeutic resistance to conventional antibiotics, repetitive negative cultures posed significant difficulty in the case management.