Document Detail


Actinomycosis of the temporal bone and brain: case report and review of the literature.
MedLine Citation:
PMID:  20524576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Actinomycosis is a rare disease with a typically indolent course in the head and neck. During the modern era, only 12 cases within the ear and temporal bone and 75 intracranial cases have been reported. We present a case of actinomycosis of the petrous apex that led to meningitis and encephalitis. METHODS: The patient was a 12-year-old girl who presented with mental status changes. After 48 hours of treatment with empiric antibiotics for meningitis without improvement, imaging revealed an enhancing mass in the right petrous apex, destruction of the cochlea, meningeal enhancement, and left temporoparietal encephalitis. RESULTS: The initial therapy included broad-spectrum antibiotic, antifungal, and antiviral agents, as well as myringotomy and tympanostomy tube placement. When the patient's clinical status worsened, she underwent subtotal petrosectomy with drainage of the petrous apex. The final pathologic findings were consistent with actinomycosis. CONCLUSIONS: Actinomycosis is a rare infection in the temporal bone and central nervous system that can have a high mortality risk if not treated appropriately. Often, these bacteria do not grow well in culture, and diagnosis must be made on the basis of histopathologic features. Good clinical outcomes can be obtained with surgical debridement followed by long-term antibiotic treatment.
Authors:
Cameron L Budenz; Bobby A Tajudeen; Pamela C Roehm
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The Annals of otology, rhinology, and laryngology     Volume:  119     ISSN:  0003-4894     ISO Abbreviation:  Ann. Otol. Rhinol. Laryngol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-07     Completed Date:  2010-06-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0407300     Medline TA:  Ann Otol Rhinol Laryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  313-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Otolaryngology, New York University School of Medicine, New York, New York 10016, USA.
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MeSH Terms
Descriptor/Qualifier:
Actinomycosis / complications*,  diagnosis,  therapy
Child
Encephalitis / diagnosis,  etiology*
Female
Humans
Meningitis, Bacterial / diagnosis,  etiology*
Temporal Bone*

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