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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of central nervous system actinomycosis is reported. A 33-year-old male complained of headache, vomiting and blurred vision lasting for eight days prior to admission. On examination, a right hemiparesis, as well an intracranial hypertension were detected. The cerebrospinal fluid showed mild lymphomononuclear hypercytosis. Necropsy disclosed three abscess in the cerebral hemispheres, in addition to moderate cerebral edema on the left side but without purulent leptomeningitis. Actinomyces filaments and granules were demonstrated in the cerebral and lung abscessess. The Brazilian literature on actinomycosis is reviewed and six published cases with nervous system involvement were found. Relevant clinical and anatomical aspects of the cases and of the present one are discussed.
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PMID:[Cerebral actinomycosis. Anatomo-clinical case report and review of the Brazilian literature]. 110 3

Infections caused by Actinomyces organisms have been demonstrated to occur in association with IUD use. Uterine actinomycosis infection is usually superficial, but it is potentially invasive. It may prove fatal. When Actinomyces is detected in a vaginal Papanicolaou smear, establishment of the correct diagnosis followed by IUD removal and appropriate antibiotic therapy are recommended. A case history is presented of a 28 year old woman who had been using an IUD and who had systemic Actinomyces infection and a brain abscess develop several years after removal of her uterus and fallopian tubes. The woman was referred to the Johns Hopkins Hospital in Baltimore in 1977 for evaluation of headaches and grand mal seizures. 4 years earlier, in 1973, she had been seen at another hospital with a recent weight loss of 18 kg. She was found to have a tubo-ovarian abscess, for which she underwent a hysterectomy, bilateral salpingectomy, and unilateral oophorectomy. At the time of surgery, an IUD was in place. A histopathological diagnosis of botryomycosis tubo-ovarian abscess was made on submitted tissues. She received no antibiotic therapy. In 1975, pulmonary infiltrates developed that were attributed to bronchopneumonia. She was treated with a short course of tetracycline hydrochloride. Later that year she was thought to have sarcoidosis and was treated for 1 year with several doses of prednisone. Clinically, her condition remained stable until March 1977, when a pyogenic subcostal abscess was drained. In July 1977, she had headache, dizziness, generalized seizures, and an incomplete right homonymous hemianopsia develop. A craniotomy for excision and drainage of an abscess was performed. The presence of Actinomyces israelii in brain tissue was confirmed by direct immunoflourescence using specific antiserum. It was confirmed that Actinomyces had been present at the time of her 1st surgical procedure. She was treated with high doses of intravenous penicillin G potassium for the first 4 weeks, followed by lower doses of oral penicillin V potassium for an additional 15 months. She recovered completely, except for a persistent right homonymous hemianopsia. The case illustrates that systemic dissemination and potentially life threatening complications of uterine actinomycosis can occur if the infection is unrecognized and/or inadequately treated.
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PMID:Systemic Actinomyces infection. A potential complication of intrauterine contraceptive devices. 712 Jun 9

A case of actinomycotic granuloma of the optic chiasma and the optic nerve is reported. A 53-year-old man was admitted to our hospital with headache and vomiting on September 25, 1989. General physical and neurological examination on admission revealed no remarkable findings. CT-scan demonstrated almost normal pictures. On the 17th hospital day, his temperature was 38 degrees C and white blood cell (WBC) count was 12000 cumm. And he presented right abducens palsy. MRI demonstrated no abnormal findings then. After antibiotic therapy of penicillin intravenously for 4 days, his temperature returned to normal and abducens palsy disappeared for two weeks. He was discharged 43 days after admission. But one year after discharge he developed progressive impairment of right visual acuity. He was admitted to our hospital again on January 19, 1991. His neurological examination revealed severe impairment of right visual acuity and bitemporal hemianopsia. WBC count was 5400 and CRP was negative and temperature was 36.2 degrees C. CT-scan and MRI demonstrated a suprasellar enhancing mass lesion. Serum prolactin was 38 ng/ml. A diagnosis of pituitary adenoma was considered and a right frontotemporal craniotomy was performed. At operation, abnormally swelled right optic nerve and chiasma were found and the swelled chiasma only was resected. Histological examination showed an abscess containing necrotic tissues and actinomycotic granules with radiating filaments. The patient was given penicillin intravenously for 37 days and orally for two months. At that time, MRI revealed no abnormal enhancing lesion, and his visual acuity improved gradually. Actinomycosis of the optic nerve and chiasma is very rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Actinomycotic granuloma of the optic chiasma: a case report]. 832 54

A diagnosis of intracranial actinomycosis was made in a 9-year-old boy with headache, cranial nerve dysfunction and ataxia. Poor dental hygiene leading to caries and an inflammation in his right upper jaw probably was the cause of cervicofacial actinomycosis with intracranial extension. A full recovery was achieved by treatment with benzylpenicillin. Actinomyces is a gram-positive bacterium belonging to the endogenous flora of the mucous membranes of the oropharynx, gastrointestinal tract, and female genital tract. Disruption of the mucous membrane is the portal of entry for an extremely destructive infective process that is effectively treated with penicillin. Good orodental hygiene is important for the prevention of actinomycosis.
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PMID:[Intracranial actinomycosis in a child with dental caries]. 1467 82

The author set out to review the thought processes of Bayard Horton as he was clinicopathologically describing the first cases of temporal arteritis. The Mayo Clinic records of the original temporal arteritis patients were examined. Horton obtained the first biopsies of the temporal arteries in temporal arteritis and was the first to describe the histopathology. Horton initially thought his first two patients had actinomycosis of the temporal arteries, but later abandoned this diagnosis. He reported these two patients in 1932 as 'an undescribed form of arteritis of the temporal vessels'. He was the first to describe jaw claudication. He saw a patient with blindness and symptoms suggestive of temporal arteritis before this complication was described in the literature, but initially felt the patient had some other disease. The sedimentation rate was elevated in his first patient. He cared for the first temporal arteritis patient ever treated with cortisone.
Cephalalgia 2007 Jan
PMID:Bayard Horton's clinicopathological description of giant cell (temporal) arteritis. 1721 86

The patient presented with right nasal obstruction, purulent secretion in nasal meatus and dull headache for 3 years. A dark brown mass, irregular in shape, surface roughness and purulent secretion adherent, was seen in the nose, touched as coal tar stone. CT examination showed high density in the right nasal meatus. Postoperative pathological examination proved to be rhinolith and actinomycosis.
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PMID:[A case of rhinolith and actinomycosis]. 2365 Jul 17

We describe the rare occurrence of an Actinomyces meyeri cerebral abscess in a 55-year-old woman following a dental extraction. This patient presented with a 2-day history of hemisensory loss, hyper-reflexia and retro-orbital headache, 7 days following a dental extraction for apical peridonitis. Neuroimaging showed a large left parietal abscess with surrounding empyema. The patient underwent craniotomy and drainage of the abscess. A. meyeri was cultured. Actinomycosis is a rare cause of cerebral abscess. The A. meyeri subtype is particularly rare, accounting for less than 1% of specimens. This case describes an unusually brief course of the disease, which is usually insidious. Parietal lobe involvement is unusual as cerebral abscesses usually have a predilection for the frontal and temporal regions of the brain. Although there are no randomised trials to guide therapy, current consensus is to use a prolonged course of intravenous antibiotics, followed by 6-12 months of oral therapy.
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PMID:Actinomyces meyeri brain abscess following dental extraction. 2587 Feb 13

Tolosa-Hunt syndrome is an idiopathic inflammatory process of the cavernous sinus or orbit manifesting as painful ophthalmoplegia. In this report, we detail the case of a 6-year-old boy who presented with several weeks of unilateral headache and diplopia. He was found to have an infiltrative process involving the bilateral cavernous sinuses and pituitary gland on MRI. Given a progressing infiltrative central nervous system process on repeat MRI and the development of cerebral salt wasting, a biopsy was performed revealing actinomycosis. To our knowledge, this is the first reported case of actinomycosis masquerading as Tolosa-Hunt syndrome in a child.
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PMID:Actinomycosis Mimicking Tolosa-Hunt Syndrome in a 6-Year-Old Boy: Case Report. 2707 Sep 54

This is a rare case report about hypertrophic cranial pachymeningitis coinfection with tuberculosis and actinomycosis in a 35-year-old male. The patient presented with progressive headache, paraesthesia, and blurred vision. Dural biopsy, histology, and cultures are imperative in pachymeningitis for establishing the diagnosis and guiding treatment.
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PMID:Hypertrophic cranial pachymeningitis coinfection with tuberculosis and actinomycosis. 3275 72

Actinomycosis of the central nervous system is extremely rare. A 73-year-old woman with a history of abdominal actinomycosis presented with sudden-onset headache. MRI demonstrated a nodular lesion at the left precentral gyrus. A cerebral angiogram confirmed a fusiform aneurysm arising from the precentral branch of the left middle cerebral artery. High-resolution vessel-wall imaging revealed circumferential wall enhancement of the aneurysm and multifocal enhancement of the M3 and M4 segments of both middle cerebral arteries. The patient had received a 4-week course of antibiotics, but follow-up angiography demonstrated no shrinkage or resolution of the aneurysm. Trapping combined with revascularization was successfully performed for refractory mycotic aneurysms.
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PMID:Intracranial Mycotic Aneurysm in a patient with Abdominal Actinomycosis. 3322 Apr 85


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