Dataset Information

Emerging role of Actinomyces meyeri in brain abscesses: A case report and literature review.

ABSTRACT: We describe a case of a 29-year-old man from Pakistan who presented with progressive neurologic symptoms over 1 week and was found to have a right parietal cerebral abscess. Neurosurgical drainage cultures showed growth of Actinomyces meyeri, Streptococcus intermedius, and Parvimonas micra. An abscessed molar was identified as the likely port of entry and was extracted. The patient was treated with metronidazole, vancomycin, and doxycycline because of prior anaphylaxis to penicillin. At 6-month follow-up, repeat magnetic resonance imaging showed no signs of residual abscess. Culture-independent identification techniques (e.g., ribosomal sequencing) increasingly identify Actinomyces meyeri as a causative agent and significant pathogen in spontaneous brain abscesses. As understanding about Actinomyces meyeri's prevalence and pathogenesis improves, questions arise about optimal treatment strategy, which we discuss based on a literature review.

SUBMITTER: Vazquez Guillamet LJ

PROVIDER: S-EPMC5554978 | biostudies-other | 2017

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:BackgroundActinomyces turicensis is rarely responsible of clinically relevant infections in human. Infection is often misdiagnosed as malignancy, tuberculosis, or nocardiosis, therefore delaying the correct identification and treatment. Here we report a case of a 55-year-old immunocompetent adult with brain abscess caused by A. turicensis. A systematic review of A. turicensis infections was performed.MethodsA systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases MEDLINE, Embase, Web of Science, CINAHL, Clinicaltrials.gov and Canadian Agency for Drugs and Technology in Health (CADTH) were searched for all relevant literature.ResultsSearch identified 47 eligible records, for a total of 67 patients. A. turicensis infection was most frequently reported in the anogenital area (n = 21), causing acute bacterial skin and skin structure infections (ABSSSI) including Fournier's gangrene (n = 12), pulmonary infections (n = 8), gynecological infections (n = 6), cervicofacial district infections (n = 5), intrabdominal or breast infections (n = 8), urinary tract infections (n = 3), vertebral column infections (n = 2) central nervous system infections (n = 2), endocarditis (n = 1). Infections were mostly presenting as abscesses (n = 36), with or without concomitant bacteremia (n = 7). Fever and local signs of inflammation were present in over 60% of the cases. Treatment usually involved surgical drainage followed by antibiotic therapy (n = 51). Antimicrobial treatments most frequently included amoxicillin (+clavulanate), ampicillin/sulbactam, metronidazole or cephalosporins. Eighty-nine percent of the patients underwent a full recovery. Two fatal cases were reported.ConclusionsTo the best of our knowledge, we hereby present the first case of a brain abscess caused by A. turicensis and P. mirabilis. Brain involvement by A. turicensis is rare and may result from hematogenous spread or by dissemination of a contiguous infection. The infection might be difficult to diagnose and therefore treatment may be delayed. Nevertheless, the pathogen is often readily treatable. Diagnosis of actinomycosis is challenging and requires prompt microbiological identification. Surgical excision and drainage and antibiotic treatment usually allow for full recovery.

Dataset Information

Emerging role of Actinomyces meyeri in brain abscesses: A case report and literature review.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets