Infect Chemother.  2014 Dec;46(4):269-273. 10.3947/ic.2014.46.4.269.

A Case of Disseminated Infection due to Actinomyces meyeri Involving Lung and Brain

• Park HJ
• Park KH
• Kim SH
• Sung H
• Choi SH
• Kim YS
• Woo JH
• Lee SO

• KMID: 2170498
• DOI: http://doi.org/10.3947/ic.2014.46.4.269

Abstract

Actinomyces meyeri is rarely isolated in cases of actinomycosis. The identification of A. meyeri had historically been difficult and unreliable. With the recent development of 16S ribosomal RNA (16S rRNA) sequencing, Actinomyces species such as A. meyeri can be isolated much more reliably. A. meyeri often causes disseminated disease, which can be secondary to frequent pulmonary infections. A penicillin-based regimen is the mainstay of A. meyeri treatment, with a prolonged course usually required. Here, we report a case of pulmonary actinomycosis with brain abscess caused by A. meyeri that was initially thought to represent lung cancer with brain metastasis.

Keyword

Actinomyces; Sequence analysis; RNA; Brain abscess

MeSH Terms

Actinomyces*
Actinomycosis
Brain Abscess
Brain*
Lung Neoplasms
Lung*
Neoplasm Metastasis
RNA
RNA, Ribosomal, 16S
Sequence Analysis
RNA
RNA, Ribosomal, 16S

Figure

• 

  Figure 1 Initial chest roentgenogram shows mass-like opacity (arrow) in the left lower lobe (A). Initial chest CT shows a 2.2 cm mass (arrow) in the left lower lobe with a spiculated border and peripheral subsegmental atelectasis (B).

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  Figure 2 Initial brain MRI shows a 3.5 cm necrotic mass with peripheral enhancement in the left frontoparietal lobe, with perilesional edma and midline shifting.

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  Figure 3 4-month follow-up chest CT shows a marked decrease in the size of the nodule in the left lower lobe.

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  Figure 4 7-month follow-up brain CT shows a subtle residual low-density lesion in the left frontal lobe cortex and subcortical white matter junction. The size of the abscess and the extent of the perilesional edema are reduced.

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