Rhinoorbitocerebral actinomycosis

Purpose: To report a case of actinomycotic orbital abscess with subdural em pyema and pansinusitis, an unusual presentation of a rarely seen infection. Methods: Case report. Results: A 35-year-old man sought treatment for signs and symptoms of an or bital abscess 22 days after a dental extraction. Computed tomography demons trated a left orbital abscess with left pansinusitis and a large subdural e mpyema. Surgical clearance of all purulent material was done followed by pr olonged penicillin therapy. Culture of pus from all sources yielded Actinom ycosis israelii. At the time of discharge and 1-month follow-up, the patien t had 20/20 vision with no neurologic deficits. Conclusions: In orbital infections with atypical presentations, unusual pat hogens should be considered as the causative agents.