Journal List > J Korean Soc Magn Reson Med > v.18(1) > 1011948

TOOLS
Lee, Lee, Chang, Jung, Kim, Lee, Kim, and Lee: Cervicofacial Actinomycosis with Orbit Involvement
Case Report

Journal of the Korean Society of Magnetic Resonance in Medicine 2014; 18(1): 70-74.

Published online: 26 March 2014

DOI: https://doi.org/10.13104/jksmrm.2014.18.1.70

Cervicofacial Actinomycosis with Orbit Involvement

Tae Young Lee1, Eun Joo Lee1, Hyuk Won Chang1, Hye Ra Jung2, Eal Maan Kim3, Hyung Lee4, Sang Pyo Kim2, Sang Kwon Lee1

1Department of Radiology, Keimyung University, Dongsan Hospital, Korea.

2Department of Pathology, Keimyung University, Dongsan Hospital, Korea.

3Department of Neurosurgery, Keimyung University, Dongsan Hospital, Korea.

4Department of Neurology, Keimyung University, Dongsan Hospital, Korea.

Corresponding author: Hyuk Won Chang, M.D., Department of Radiology, Keimyung University Dongsan Hospital, 216 Dalsungro, Jung-gu, Daegu 700-712, Korea. Tel. 82-53-250-7767, Fax. 82-53-250-7786, laguna_omega@hanmail.net

Received 9 November 2013       Revised 3 March 2014       Accepted 4 March 2014

Copyright © 2014 Journal of the Korean Society of Magnetic Resonance in Medicine

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Actinomycosis is caused by filamentous Gram positive anaerobic bacteria from the Actinomycetaceae family, and known as a rare cause of the infection at the eyeball. We report magnetic resonance findings of a 60-year-old Korean man with cervicofacial actinomycosis, including cellulitis in the eye and central nervous system actinomycosis. On orbital magnetic resonance imaging, gadolinium-enhanced T1-weight images showed multiple abnormal enhancing lesions in head and neck including right eye, and some include low signal intensities which considered as abscesses. The lesions was diagnosed as actinomycosis by incisional biopsy, and since then was cured by using antibiotics of penicillin family.

Keywords: Actinomycosis, Orbital, Cervicofacial, Cellulitis

Figures and Tables

Fig. 1
T1- (a) T2-wieghted (b), and axial Gadolinium-enhanced T1-weighted magnetic resonance imaging (c, d) scans of orbit showing inflammatory process of the right temporalis muscle (arrow), osteomyelitis of the right sphenoid bone (arrow head), slit like abscess at the right upper eyelid (open arrow) and inflammatory process of the right optic canal (open arrow head).
jksmrm-18-70-g001
Fig. 2
Positron emission tomography scans showing multifocal intensity hypermetabolic lesions in (a) right optic canal (arrow) (b) right upper eyelid (arrow) and right sphenoid bone (arrow head).
jksmrm-18-70-g002
Fig. 3
Photomicrograph of histopathologic specimen shows numerous radiating filamentous actinomyces colony. The sulfur granule (pink-purple colored granule in Hematoxylin and eosin stain) is surrounded by lymphocytes at periphery.
jksmrm-18-70-g003
Fig. 4
Follow up gadolinium-enhanced axial T1-weighted magnetic resonance imaging (MRI) scans of orbit showing no evidence of abnormal signal intensity lesion in brain, except surgical metallic artifact in right frontotemporal area.
jksmrm-18-70-g004

References

1. Acevedo F, Baudrand R, Letelier LM, Gaete P. Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature. Int J Infect Dis. 2008; 12:358–336.
2. Wong VK, Turmezei TD, Weston VC. Actinomycosis. BMJ. 2011; 343:d6099.
3. Harvey JC, Cantrell JR, Fisher AM. Actinomycosis: its recognition and treatment. Ann Intern Med. 1957; 46:868–885.
4. Belmont MJ, Behar PM, Wax MK. Atypical presentations of actinomycosis. Head Neck. 1999; 21:264–268.
5. Weese WC, Smith IM. A study of 57 cases of actinomycosis over a 36-year period. A diagnostic 'failure' with good prognosis after treatment. Arch Intern Med. 1975; 135:1562–1156.
6. Nithyanandam S, D'Souza O, Rao SS, Battu RR, George S. Rhinoorbitocerebral actinomycosis. Ophthal Plast Reconstr Surg. 2001; 17:134–136.
7. Wallace RJ Jr, Musher DM. Actinomycosis: an update. Int J Dermatol. 1977; 16:185–187.
8. Smego RA Jr. Actinomycosis of the central nervous system. Rev Infect Dis. 1987; 9:855–865.
9. Pagliani L, Campi L, Cavallini GM. Orbital actinomycosis associated with painful ophthalmoplegia. Actinomycosis of the orbit. Ophthalmologica. 2006; 220:201–205.
10. Ho L, Seto J, Jadvar H. Actinomycosis mimicking anastomotic recurrent esophageal cancer on PET-CT. Clin Nucl Med. 2006; 31:646–647.
TOOLS
Similar articles