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Un trabajo de varios años ademas de raro.
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Brain Actinomycosis: Brain Actinomycosis: Report of one caseReport of one case
Jorge L. Rivera-Rodriguez, MD, Jorge L. Rivera-Rodriguez, MD, Eugenia Zurita,CNS.Eugenia Zurita,CNS.
Hospital General de Acapulco SSAHospital General de Acapulco SSA
MéxicoMéxico
IntroductionIntroduction
Actinomycosis is an infection primarily Actinomycosis is an infection primarily caused by the bacterium caused by the bacterium Actinomyces Actinomyces israelii.israelii.
Actinomycosis located in the central nervous Actinomycosis located in the central nervous system is an extremely uncommon event.system is an extremely uncommon event.
It may affect immunocompetent or It may affect immunocompetent or immunodefficient subjects.immunodefficient subjects.
It is commonly misdiagnosed in routine It is commonly misdiagnosed in routine imaging studiesimaging studies
Medical HistoryMedical History
Female, 32 y.o. Previously healthy. Recent Female, 32 y.o. Previously healthy. Recent onset of right extremities partial motor onset of right extremities partial motor epilepsy.epilepsy.
A Brain scan showed: left parietal 2 cm solid A Brain scan showed: left parietal 2 cm solid mass, IV contrast inhancing, important mass, IV contrast inhancing, important periferic oedema.periferic oedema.
Negative Chest XrayNegative Chest Xray
No neck masses.No neck masses.
Preoperative ScanPreoperative Scan
Differential DiagnosisDifferential Diagnosis
Primary tumor.Primary tumor.
Brain Abscess.Brain Abscess.
Granuloma.Granuloma.
A parietal craniotomy and total resection of A parietal craniotomy and total resection of the lesion was performed.the lesion was performed.
Hystopathological report:Hystopathological report:
Brain ActinomycosisBrain Actinomycosis
Postoperative Brain ScanPostoperative Brain Scan
No additional No additional antimycrobial therapy antimycrobial therapy was given.was given.Total neurological Total neurological recovery.recovery.Clean long term Clean long term scanning.scanning.Seizure free without Seizure free without antiepileptic drugs at antiepileptic drugs at present.present.
ConclusionsConclusions
Brain Actinomycosis is a rare entity and Brain Actinomycosis is a rare entity and should be considered in any brain mass should be considered in any brain mass differential diagnosis.differential diagnosis.
Total surgical removal without long term Total surgical removal without long term antimycrobial therapy seems to be antimycrobial therapy seems to be effective, but more studies should be effective, but more studies should be performed.performed.
BibliographyBibliography
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