J Korean Soc Magn Reson Med.  2014 Mar;18(1):70-74. 10.13104/jksmrm.2014.18.1.70.

Cervicofacial Actinomycosis with Orbit Involvement

• Lee TY
• Lee EJ
• Chang HW
• Jung HR
• Kim EM
• Lee H
• Kim SP
• Lee SK

• KMID: 1683783
• DOI: http://doi.org/10.13104/jksmrm.2014.18.1.70

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.

Keyword

Actinomycosis; Orbital; Cervicofacial; Cellulitis

MeSH Terms

Abscess
Actinomycetaceae
Actinomycosis
Actinomycosis, Cervicofacial*
Anti-Bacterial Agents
Bacteria, Anaerobic
Biopsy
Cellulitis
Central Nervous System
Head
Humans
Magnetic Resonance Imaging
Middle Aged
Neck
Orbit*
Penicillins
Anti-Bacterial Agents
Penicillins

Figure

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  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).

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  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).

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  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.

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  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.

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