Cranial epidural empyema with osteomyelitis caused by actinomyces, CT, andMRI appearance

Actinomycosis is an uncommon cause of intracranial infection, Epidural empy ema represents about 6% of CNS actinomycotic lesions. A case of an epidural empyema with parietal bone osteomyelitis caused by Actinomyces israelii is presented. Relevant neuroimaging features were bone erosions and a multilo culated collection with annular contrast enhancing on CT. Postoperative MRI revealed extensive involvement of the neighbor dura, fair, and subdural sp ace. MRI tvas crucial to follow-up the response to antibiotic treatment. (C ) Elsevier Science Inc., 1999.