TY - JOUR
T1 - Giant Actinomyces brain abscess in an immunocompetent child
T2 - A management strategy
AU - Chicoine, Nicole H.Nchicoine
AU - Griffith-Linsley, Jackson
AU - Goh, Joling
AU - Manaloor, John J.
AU - Raskin, Jeffrey S.
N1 - Publisher Copyright:
© 2021 Scientific Scholar. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: Intraparenchymal brain abscess is a collection of microbes caused by inoculation through direct extension or hematogenous spread. Although rare, intraparenchymal abscesses are potentially fatal and can be detected when patients are symptomatic due to local mass effect on adjacent neural tissue. Brain abscess treatment includes medical management with appropriate antibiotics alone or medical management in combination with surgical debridement. Treatment strategies depend on the size and location of disease, as well as the virulence of the microorganism. Similar to medical management strategies, surgical strategies among providers are not uniform, with variation in approaches from complete extirpation of the abscess, including the abscess wall, to minimally invasive stereotactic needle aspiration. In particular, for children, there are no guidelines for therapy. Case Description: We report a case of giant Actinomycosis right frontal brain abscess in an immunocompetent child without risk factors. A review of the literature for the treatment of brain abscess caused very rarely by Actinomyces in children is performed. Conclusion: Successful treatment of brain access depends on organism and location. The even more uncommon giant intraparenchymal abscesses can be managed with minimal access and prolonged antibiosis, especially when slow-growing organisms are identified. Long-Term follow-up should be employed to mitigate missed late failures.
AB - Background: Intraparenchymal brain abscess is a collection of microbes caused by inoculation through direct extension or hematogenous spread. Although rare, intraparenchymal abscesses are potentially fatal and can be detected when patients are symptomatic due to local mass effect on adjacent neural tissue. Brain abscess treatment includes medical management with appropriate antibiotics alone or medical management in combination with surgical debridement. Treatment strategies depend on the size and location of disease, as well as the virulence of the microorganism. Similar to medical management strategies, surgical strategies among providers are not uniform, with variation in approaches from complete extirpation of the abscess, including the abscess wall, to minimally invasive stereotactic needle aspiration. In particular, for children, there are no guidelines for therapy. Case Description: We report a case of giant Actinomycosis right frontal brain abscess in an immunocompetent child without risk factors. A review of the literature for the treatment of brain abscess caused very rarely by Actinomyces in children is performed. Conclusion: Successful treatment of brain access depends on organism and location. The even more uncommon giant intraparenchymal abscesses can be managed with minimal access and prolonged antibiosis, especially when slow-growing organisms are identified. Long-Term follow-up should be employed to mitigate missed late failures.
KW - Actinomyces
KW - Brain abscess
KW - Medical management
KW - Surgical
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U2 - 10.25259/SNI_164_2021
DO - 10.25259/SNI_164_2021
M3 - Article
C2 - 34345466
AN - SCOPUS:85109723897
SN - 2152-7806
VL - 12
JO - Surgical Neurology International
JF - Surgical Neurology International
M1 - 325
ER -