[Multiple actinomycosis brain abscesses].
BACKGROUND
Actinomycosis is a subacute or chronic bacterial infection, which can affect immunocompetent or immunodeficient subjects. It most often occurs in cervico-facial or thoracic-abdominal locations. Central nervous system infection is rare but of severe prognosis.


METHODS
A 56 year-old woman with no history of immunodepression was admitted with unexplained fever, inappropriate behaviour, and spatial and temporal disorientation. The progressive worsening of the neurological signs let to coma and mechanical ventilation was required. Brain imaging showed multilocation cerebral abscesses. Stereotaxial biopsy permitted diagnosis of actinomycosis. Patient's outcome was favourable following appropriate dual antibiotherapy without surgical exeresis.


CONCLUSIONS
When lacking bacteriologic identification, diagnosis of cerebral actinomycosis is performed by pathologic findings. Dual antibiotherapy allows full recover, even in the case of multilocation cerebral abscesses.
Liotier
J
J
Service de réanimation polyvalente, hôpital Bellevue, Saint-Etienne. jliotier@chu-clermontferrand.fr
Venet
C
C
Chambonnière
M-L
ML
Fournier
C
C
Fotso
M-J
MJ
Ewencsyk
I
I
Barral
F-G
FG
Carricajo
A
A
Robert
F
F
Lucht
F
F
Mosnier
J-F
JF
Zéni
F
F
D000190:Actinomyces / Q000302:isolation & purification; D000196:Actinomycosis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D000212:Acyclovir / Q000008:administration & dosage / Q000627:therapeutic use; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D001922:Brain Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D002701:Chloramphenicol / Q000008:administration & dosage / Q000627:therapeutic use; D002981:Clindamycin / Q000008:administration & dosage / Q000627:therapeutic use; D003128:Coma / Q000209:etiology; D003951:Diagnostic Errors; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D020803:Encephalitis, Herpes Simplex / Q000175:diagnosis; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D008088:Listeriosis / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008590:Meningoencephalitis / Q000175:diagnosis; D008875:Middle Aged; D009617:Nocardia Infections / Q000175:diagnosis; D012074:Remission Induction; D014390:Tuberculosis, Meningeal / Q000175:diagnosis
D002981:Clindamycin; D002701:Chloramphenicol; D000658:Amoxicillin; D000212:Acyclovir