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January 1968

Secondary Actinomycotic Brain Abscess: Isolation of a New Species and Review

Author Affiliations

Palo Alto, Calif
From the Division of Neurosurgery, Stanford University School of Medicine, Palo Alto, Calif.

Arch Surg. 1968;96(1):58-64. doi:10.1001/archsurg.1968.01330190060014

ALTHOUGH there have been numerous reports of cerebral actinomycotic infection since Ponfick's original description in 1882, the sporadic occurrence of this potentially remediable infection justifies a disinclination to hold Actinomyces israelii suspect as an etiologic agent in meningitis and brain abscess. Characteristics which are unique, but not specific for this anaerobic mycelial organism favor further this disregard; per contra, when taken together, one may be alerted to its presence.

Actinomyces israelii, a saprophyte and parasite in man, may be distinguished from A bovis, the responsible agent of "lumpy jaw" in cattle.1 Its ubiquitous presence within the oropharynx of man is usually accompanied by no clinical manifestations.2-4 Whereas the most prevalent site of primary infection was reported as cervicofacial in 1938 by Cope,5 a more recent series from the Johns Hopkins Hospital shows 63% of cases were abdominal, 24% cervicofacial and 13% lung.6 There is usually a

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