RESUMO
BACKGROUND: The actinomyces is germ commonly found in the normal flora of the oral cavity and gastro-intestinal and uro-genital tracts. Involvement in other locations is a very uncommon event. OBJECTIVES: To describe a patient with an actinomicotyc brain abscess CLINICAL CASE: We report the case of a patient who suffered a seizure and decreased level of consciousness. Imaging tests revealed the presence of lesions both in the lung and in the brain. An urgent craniotomy was performed and the diagnosis of actinomicotyc abscess was obtained. CONCLUSION: We describe the differential characteristics of this type of infection, discussing the diagnostic process and management in detail.
Assuntos
Actinomicose/microbiologia , Abscesso Encefálico/microbiologia , Actinomicose/complicações , Actinomicose/diagnóstico por imagem , Actinomicose/cirurgia , Adulto , Antibacterianos/uso terapêutico , Abscesso Encefálico/complicações , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/cirurgia , Coinfecção , Terapia Combinada , Craniotomia , Diagnóstico Diferencial , Emergências , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/microbiologia , Lobo Frontal/patologia , Lobo Frontal/cirurgia , Cefaleia/etiologia , Humanos , Imunocompetência , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/microbiologia , Imageamento por Ressonância Magnética , Masculino , Neuroimagem , Paralisia/etiologia , Convulsões/etiologia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Streptococcus intermedius/isolamento & purificação , Tomografia Computadorizada por Raios XRESUMO
Pneumococcal meningitis is a life-threatening disease characterized by an acute infection affecting the pia matter, arachnoid and subarachnoid space. The intense inflammatory response is associated with a significant mortality rate and neurologic sequelae, such as, seizures, sensory-motor deficits and impairment of learning and memory. The aim of this study was to evaluate the effects of acute and extended administration of cannabidiol on pro-inflammatory cytokines and behavioral parameters in adult Wistar rats submitted to pneumococcal meningitis. Male Wistar rats underwent a cisterna magna tap and received either 10µl of sterile saline as a placebo or an equivalent volume of S. pneumoniae suspension. Rats subjected to meningitis were treated by intraperitoneal injection with cannabidiol (2.5, 5, or 10mg/kg once or daily for 9 days after meningitis induction) or a placebo. Six hours after meningitis induction, the rats that received one dose were killed and the hippocampus and frontal cortex were obtained to assess cytokines/chemokine and brain-derived neurotrophic factor levels. On the 10th day, the rats were submitted to the inhibitory avoidance task. After the task, the animals were killed and samples from the hippocampus and frontal cortex were obtained. The extended administration of cannabidiol at different doses reduced the TNF-α level in frontal cortex. Prolonged treatment with canabidiol, 10mg/kg, prevented memory impairment in rats with pneumococcal meningitis. Although descriptive, our results demonstrate that cannabidiol has anti-inflammatory effects in pneumococcal meningitis and prevents cognitive sequel.