| Actinomycosis of the temporal bone and brain: case report and review of the literature. | |
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MedLine Citation:
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PMID: 20524576 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Cameron L Budenz; Bobby A Tajudeen; Pamela C Roehm |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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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:
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Created Date: 2010-06-07 Completed Date: 2010-06-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0407300 Medline TA: Ann Otol Rhinol Laryngol Country: United States |
Other Details:
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Languages: eng Pagination: 313-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Otolaryngology, New York University School of Medicine, New York, New York 10016, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Actinomycosis
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complications*,
diagnosis,
therapy Child Encephalitis / diagnosis, etiology* Female Humans Meningitis, Bacterial / diagnosis, etiology* Temporal Bone* |
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