Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지

Thoracic Actinomycosis Causing Spinal Cord Compression

  • Kim, In-Soo (Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine)
  • Published : 2006.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

Thoracic spinal actinomycosis causing epidural abscess and significant spinal cord compression is very rare. A case is presented of a 56-year-old woman with rapid progressive upper back pain and weakness in both legs without evidence of systemic infection. Magnetic resonance imaging revealed a thoracic epidural enhancing lesion at the T1-T5 level. After decompression by laminectomy, precise diagnosis was accomplished using specific histopathological studies of the surgical specimens. A histopathologic findings showing typical Actinomyces sulfur granules surrounded by acute inflammatory cells. The clinical radiological findings of spinal actinomycosis closely resemble metastatic tumors and other infectious processes. Delay in diagnosis and treatment can significantly worsen the condition of patient.

Keywords

References

  1. Alday R, Lopez-Ferro MO, Fernandez-Guerrero M, Ruiz-Barnes P : Spinal intrathecal empyema due to Actinomyces israelii. Acta Neurochir 101 : 159-162, 1989 https://doi.org/10.1007/BF01410532
  2. Brown JR : Human Actinomycosis. A study of 181 subjects. Hum Pathol 4 : 319-330, 1973 https://doi.org/10.1016/S0046-8177(73)80097-8
  3. Chen-Wei H : Actinomycosis of the brain : Case report. J Neurosurg 63 : 131-133, 1985 https://doi.org/10.3171/jns.1985.63.1.0131
  4. Cope VZ : Actinomycosis of bone with special reference to infection of the vertebral column. J Bone Joint Surg 33B : 205-214, 1951
  5. Crank RN, Sundaram M, Shields JB : Case report 197. Cervical actinomycosis with spinal involvement. Skeletal Radiol 8 : 164-167, 1982 https://doi.org/10.1007/BF00349587
  6. Eftekhar B, Ketabchi E, Ghodsi M, Ahmadi A : Cervical epidural actinomycosis. J Neurosurg (Suppl 1) 95 : 132-134, 2001 https://doi.org/10.3171/jns.2001.95.1.0132
  7. Ernst J, Ratjen E : Actinomycosis of the spine : Report of two cases. Acta Orthop Scand 42 : 35-44, 1971 https://doi.org/10.3109/17453677108989023
  8. Garrod LP : The sensitivity of Actinomyces israelii to antibiotics. Br Med Jr 1 : 1263-1264, 1952 https://doi.org/10.1136/bmj.1.4771.1263
  9. Kannangara DW, Tanaka T, Thadepalli H : Spinal epidural abscess due to Actinomyces israelii. Neurology 31 : 202-204, 1981 https://doi.org/10.1212/WNL.31.2.202
  10. Kaplan AH, Weber DJ, Oddone EZ, Perfect JR : Infection due to Actinobacillus actinomycetem comitans : 15 cases and review. Rev Infect Dis 11 : 46-63, 1989 https://doi.org/10.1093/clinids/11.1.46
  11. Kim KY, Cho KH, Ahn YM, Kim SH, Ahn YH, Yoon SH, et al : A Surgical Treatment of the Cervicothoracic Spinal Actinomycosis with Spinal Cord Compression. J Korean Neurosurg Soc 27 : 381-386, 1998
  12. Kirsch WM, Stears JC : Actinomycotic osteomyelitis of the skull and epidural space. Case report. J Neurosurg 33 : 347-351, 1970 https://doi.org/10.3171/jns.1970.33.3.0347
  13. Lane T, Goings S, Fraser DW, Ries K, Pettrozzi J, Abrutyn E : Disseminated actinomycosis with spinal cord compression: report of two cases. Neurology 29 : 890-893, 1979 https://doi.org/10.1212/WNL.29.6.890
  14. Lerner PI : Susceptibility of pathogenic actinomycetes to antimicrobial compounds. Antimicrob Agents Chemother 5 : 302-309, 1974 https://doi.org/10.1128/AAC.5.3.302
  15. Lerner PI : Actinomyces and Arachnia species, in Mandell GL, Douglas RG Jr, Bennett JE (eds) : Principles and Practice of Infectious Disease, ed 2. New York : John Wiley & Sons Inc., 1985, pp1427-1433
  16. Muller PG : Actinomycosis as a cause of spinal cord compression : a case report and review. Paraplegia 27 : 390-393, 1989 https://doi.org/10.1038/sc.1989.61
  17. Oruckaptan HH, Senmevsim O, Soylemezoglu F, Ozgen T : Cervical actinomycosis causing spinal cord compression and multisegmental root failure : case report and review of the literature. Neurosurgery 43 : 937-940, 1998 https://doi.org/10.1097/00006123-199810000-00118
  18. Smego RA : Actinomycosis of the central nervous system. Rev Infec Dis 9 : 855-865, 1987 https://doi.org/10.1093/clinids/9.5.855
  19. Sundaram C, Purohit AK, Prasad VS, Meena AK, Reddy JJ, Murthy JM : Cranial and intracranial actinomycosis. Clin Neuropathol 23 : 173-177, 2004
  20. Tekkok IH, Berker M, Ozcan OE, Ozgen T, Akalin E : Brucellosis of the spine. Neurosurgery 33 : 838-844, 1993 https://doi.org/10.1227/00006123-199311000-00008
  21. Voisin L, Vittecoq O, Mejjad O, Krzanowska C, Defives T, Cambon-Michot C, et al : Spinal abscess and spondylitis due to actinomycosis. Spine 23 : 487-490, 1998 https://doi.org/10.1097/00007632-199802150-00016
  22. Young WB : Actinomycosis with involvement of the vertebral column. Case report and review of the literature. Clin Radiol 11 : 175-182, 1960 https://doi.org/10.1016/S0009-9260(60)80014-1