CERVICAL ACTINOMYCOSIS CAUSING SPINAL-CORD COMPRESSION AND MULTISEGMENTAL ROOT FAILURE - CASE-REPORT AND REVIEW OF THE LITERATURE

OBJECTIVE AND IMPORTANCE: Epidural invasion and the resulting cord com pression are clinical entities not usually associated with actinomycos is, and we found only 11 reported cases of cord compression caused by Actinomyces infection in the literature. Only one reported case was de scribed as actinomycosis with epidural granuloma (14, 16), whereas in the other cases, epidural macroabscess (phlegm) formation caused the s ymptoms. Histopathological demonstration of the inflammatory granulati on tissue and gram-positive sulfur-containing filamentous bacteria are important for the diagnosis of actinomycosis, because the clinical an d microbiological studies cannot always demonstrate the causative micr oorganism and primary infection source. CLINICAL PRESENTATION: In this article, a case of Actinomyces infection causing cervical cord compre ssion is presented. Precise diagnosis was accomplished using specific histopathological studies of the surgical specimens; such a precise di agnosis cannot always be achieved using preoperative investigations an d microbiological studies. The treatment modalities and the patient's outcome are also discussed. CONCLUSION: As shown by hematoxylin and eo sin stain, in contrast to the Nocardia species, Actinomyces filaments histopathologically are basophilic in nature and terminate in eosinoph ilic clubs as a predictive feature. The clinical and radiological find ings closely resemble metastatic tumors and other infectious processes . A differential diagnosis is also emphasized in this article, along w ith a review of the literature.