Koda Yoshiro, Seto Yoshihisa, Takeichi Sanae, Kimura Hiroshi
Department of Forensic Medicine, Kurume University School of Medicine, 830-0011 Kurume, Japan.
Forensic Sci Int. 2003 Jul 8;134(2-3):169-71. doi: 10.1016/s0379-0738(03)00133-6.
Actinomycosis is caused by Gram-positive Actinomyces species that are part of the normal oral flora with low virulence. We describe a rare case of sudden death of a 48-year-old man with actinomycotic basilar meningitis that was complicated by fatal subarachnoid hemorrhage. Autopsy revealed meningitis at the basilar region of the brain, and histological examination revealed characteristic bacterial aggregates with extensive leukocyte infiltration and severe vasculitis of arteries of this region. Rupture of an artery by severe arteritis was thought to be the cause of the subarachnoid hemorrhage. The probable primary source of infection was found in the left lung. To the best of our knowledge, the complication of subarachnoid hemorrhage has not been reported previously in actinomycotic meningitis.
放线菌病由革兰氏阳性放线菌引起，这些菌是正常口腔菌群的一部分，毒力较低。我们描述了一例罕见的48岁男性因放线菌性基底脑膜炎并发致命性蛛网膜下腔出血而猝死的病例。尸检发现脑基底区域有脑膜炎，组织学检查显示有特征性的细菌聚集体，伴有广泛的白细胞浸润和该区域动脉的严重血管炎。严重动脉炎导致的动脉破裂被认为是蛛网膜下腔出血的原因。感染的可能主要来源在左肺。据我们所知，放线菌性脑膜炎并发蛛网膜下腔出血此前尚未见报道。
