Liotier J, Venet C, Chambonnière M-L, Fournier C, Fotso M-J, Ewencsyk I, Barral F-G, Carricajo A, Robert F, Lucht F, Mosnier J-F, Zéni F
Service de réanimation polyvalente, hôpital Bellevue, Saint-Etienne.
Presse Med. 2004 Mar 13;33(5):318-20. doi: 10.1016/s0755-4982(04)98572-7.
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.
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.
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.
放线菌病是一种亚急性或慢性细菌感染，可影响免疫功能正常或免疫功能低下的个体。它最常发生在头颈部或胸腹部。中枢神经系统感染罕见但预后严重。
一名56岁无免疫抑制病史的女性因不明原因发热、行为异常以及时空定向障碍入院。神经体征进行性恶化导致昏迷，需要机械通气。脑部影像学检查显示多处脑脓肿。立体定向活检确诊为放线菌病。经过适当的双联抗生素治疗且未进行手术切除，患者预后良好。
在缺乏细菌学鉴定的情况下，脑放线菌病的诊断依靠病理检查结果。双联抗生素治疗即使在存在多处脑脓肿的情况下也能实现完全康复。
