Actinomycosis of the Nervous System

Publisher Website
Google Scholar
Abstract
Actinomycosis may be due to Actinomyces bovis or Nocardia asteroides. The latter is more virulent but either may invade the central nervous system and produce morbid changes similar to bacterial infection. Acid-fast staining and culture on conventional media of purulent material from a draining abscess or sinus, is necessary to establish the etiological diagnosis. Generally, the cervico-facial area, thorax abdomen is the site of primary involvement. Rarely, Madura foot (due to N. asteroides) is the primary site. Cerebral abscess, meningitis, or both are the usual consequences of central nervous system invasion. Much rarer is actinomycoma. An instance of the latter is reported, due to nocardiosis. Two additional fatal cases of actinomycosis and two autopsies are descr. and illustrated. A 4th patient, treated with antibiotics and surgical excision of cerebral abscess is surviving over 8 yrs. later, the longest on record. Differential diagnosis is outlined, recent literature reviewed, and modern therapeutic measures enumerated.