Cerebral Actinomycosis before Adolescence

Abstract

In a 10-year-old boy presenting with focal seizures and 6 months later with acute right-sided hemiparesis, the diagnosis of a cerebral abscess due to Actinomyces israelii was established. The immunocompetent child suffered from a complex congenital heart disease with pulmonary arteriovenous shunts and pulmonary hypertension causing mild cyanosis. His parents had been reluctant to agree to neuroimaging investigations resulting in a delayed diagnosis. Despite the long interval between first symptoms and commencement of treatment including neurosurgical excision of the abscess followed by a 4-week course of ceftriaxone, a complete recovery of the hemiparesis was observed. This patient is the first case with cerebral actinomycosis before adolescence reported so far.

Airway foreign bodies and brain abscesses: Report of two cases and review of the literature

“…Although the bronchial culture did not grow Actinomyces, the aspiration of oral secretions into the lung is the likely source of the brain isolate in case 1. The only other report of an Actinomyces brain abscess in an adolescent was in a child with complex congenital heart disease with a right-to-left cardiac shunt [12]. As seen in case 1, Endobronchial foreign bodies and brain abscess 267 Actinomyces often accompany polymicrobial infections.…”

Intracerebral Abscess Caused by Actinomyces israelii

“…Pediatric cerebral actinomycosis cases are rare. A cerebral abscess caused by Actinomyces israelii was detected in a 10-year-old boy with congenital heart disease and successfully treated with neurosurgical excision followed by a 4-week course of ceftriaxone [7].…”

A case of otitis media complicated by intracranial infection with Actinomyces turicensis

“…The case is also remarkable in that actinomycosis infection is most common in the third decade of life and is particularly rare in children ( Gazzano et al , 2010 ; Puzzilli et al , 1998 ). Olah et al (2004) described a 10-year-old boy with a background of complex congenital heart disease who was diagnosed with cerebral abscess secondary to A. israelii . This patient also underwent neurosurgical intervention and was successfully treated with a 4-week course of ceftriaxone.…”