A rare and an unusually delayed presentation of orbital actinomycosis following avulsion injury of the scalp

Abstract

We report a rare case of orbital swelling presenting one year after head trauma. An initial fine needle aspiration cytology revealed it to be an infected organizing hematoma. However, broad-spectrum antibiotics did not resolve the infection and the orbital lesion continued to grow in size, as evaluated by magnetic resonance imaging. Incisional biopsies were done, which were reported as orbital actinomycosis. Patient has responded well to treatment with penicillin. This case is of interest due to the delayed presentation of an orbital complication of head trauma and the rare infection with actinomyces. It also highlights the importance of using appropriate antibiotics, as well as the need for long-term treatment.

Actinomycosis of the scalp or tuberculosis? A clinical conundrum!

“…It is characterised by contiguous spread, suppurative and granulomatous inflammation, and formation of multiple abscesses and sinus tracts that may discharge sulfur granules 2. Common clinical forms are cervicofacial, thoracic and abdominal and in women, pelvic actinomycosis 3. Tuberculous osteomyelitis mimics actinomycosis, causing a diagnostic dilemma and only a biopsy can confirm the diagnosis.…”