Background: Brain abscesses are serious, life-threatening infections that require prompt diagnosis and treatment. Although Actinomyces species are recognized causes of brain abscesses, infections caused by Actinomyces urogenitalis and Peptoniphilus asaccharolyticus are exceptionally rare and, to our knowledge, have not been previously reported. Case Description: We describe a 62-year-old man with a long history of chronic bilateral otitis media who presented with progressive vertigo, severe hemicranial headache, nausea, and vomiting. Within hours of admission, his neurological status worsened, leading to urgent neuroimaging that revealed a right temporal brain abscess associated with subfalcine herniation. The patient underwent emergent craniotomy with abscess drainage. Microbiological cultures identified A. urogenitalis and P. asaccharolyticus . He was treated with prolonged intravenous antibiotics followed by oral therapy, achieving complete clinical recovery and full radiological resolution of the lesion. Conclusion: This report documents the first known case of a brain abscess caused by A. urogenitalis and P. asaccharolyticus . The case emphasizes the importance of considering unusual pathogens in brain abscesses and highlights the value of early surgical management combined with targeted, long-term antimicrobial therapy.
Chacón et al. (Fri,) studied this question.