In a 10-year-old boy presenting with focal seizures and 6 months later with acute
right-sided hemiparesis, the diagnosis of a cerebral abscess due to Actinomyces israelii was established. The immunocompetent child suffered from a complex congenital heart
disease with pulmonary arteriovenous shunts and pulmonary hypertension causing mild
cyanosis. His parents had been reluctant to agree to neuroimaging investigations resulting
in a delayed diagnosis. Despite the long interval between first symptoms and commencement
of treatment including neurosurgical excision of the abscess followed by a 4-week
course of ceftriaxone, a complete recovery of the hemiparesis was observed. This patient
is the first case with cerebral actinomycosis before adolescence reported so far.
Hemiparesis - seizures - brain abscess -
Actinomyces israelii
