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Description

Actinomycosis may spread to involve the central nervous system (CNS).


 

CNS involvement may take the form of:

(1) one or more brain abscesses, especially in the frontal and/or temporal lobes

(2) meningitis, which may be basilar

(3) meningoencephalitis

(4) subdural empyema

(5) epidural abscess around the brainstem or spinal cord

(6) actinomycoma

 

Sources:

(1) paranasal sinuses

(2) ears

(3) other cervicofacial sites of involvement

(4) hematogenous spread from focus of actinomycosis within the thorax or abdomen

(5) disseminated actinomycosis

 

Culture of a focus of CNS actinomycosis may show pure growth of an Actinomycosis species or mixed isolates including an Actinomycosis species.

 

The diagnosis may be delayed if:

(1) the patient is afebrile

(2) indolent or nonspecific clinical findings

 

Differential diagnosis:

(1) tuberculous meningitis

(2) other causes of brain abscess

(3) brain tumor

(4) intracranial aneurysm

(5) cholesteatoma

 


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