[Cerebral actinomycosis pseudotumor: a case report].
BACKGROUND
Cerebral actinomycosis is rare and difficult to diagnose.


METHODS
We report a case of a 45-year-old man hospitalized for seizures associated with fever and left hemiparesis. The white cell count and C-reactive protein were elevated. HIV serology was negative. Blood cultures remained sterile. The CT scan revealed hyperdense nodular lesions in the occipital area, with annular contrast uptake and peripheral edema causing a mass effect, suggestive of brain metastasis. The pathology examination of a surgical specimen disclosed cerebral actinomycosis. A dental origin of the infection was suspected. Hemiparesis remained after a 12-month antibiotic regimen associated with dental care and short-term corticosteroid therapy.


CONCLUSIONS
Actinomycosis should be discussed as a possible diagnosis for all cerebral lesions, particularly in patients with a potential dental infection. Histology is required for positive diagnosis. Antibiotic therapy alone is generally sufficient; surgery is often performed for diagnostic purposes.
Service de médecine interne, hôpital militaire principal d'instruction de Tunis, Montfleury 1008, Tunisia. battikh_riadh@yahoo.fr
R
R
Battikh
F
F
M'Sadek
F
F
Bougrine
W
W
Madhi
N
N
Ben Abdelhafidh
A
A
Bouziani
M
M
Yedeas
S
S
Othmani
D000196:Actinomycosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003731:Dental Caries / Q000150:complications / Q000382:microbiology; D004359:Drug Therapy, Combination; D004401:Dysarthria / Q000209:etiology; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000382:microbiology; D009910:Oral Hygiene; D010291:Paresis / Q000209:etiology; D010400:Penicillin G / Q000008:administration & dosage / Q000627:therapeutic use; D010482:Periapical Abscess / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D011559:Pseudotumor Cerebri / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000601:surgery; D012640:Seizures / Q000209:etiology; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002939:Ciprofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination; D010400:Penicillin G