title: Orbital actinomycosis associated with painful ophthalmoplegia. Actinomycosis of the orbit.
abstract: OBJECTIVE
  To evaluate a case of orbital actinomycosis presenting as Tolosa-Hunt syndrome in a patient with a history of carcinomas of the kidney and breast.
  
  
  METHODS
  A woman with ingravescent painful ophthalmoplegia was brought to our observation. Brain and orbital and total body CT scans showed the presence of two orbital neoformations and a miliary pattern of dissemination in the lung. The initial diagnosis, which pointed to secondary localisations of the previous kidney and breast tumours, was changed to orbital and pulmonary actinomycosis following microbiological analysis of lung biopsy samples.
  
  
  RESULTS
  Prolonged antibiotic therapy with synthetic penicillin completely resolved the case.
  
  
  CONCLUSIONS
  Actinomycosis is a very rare infection that may also affect the orbit and its association with a pulmonary dissemination is highly unusual. It is important to consider this type of infection among the causes of painful ophthalmoplegia.
authors: Dipartimento Misto di Neuroscienze, Testa, Collo e Riabilitazione, Università degli Studi di Modena e Reggio Emilia, Struttura Complessa di Oftalmologia, Modena, Italia.
authors: Livio
authors: L
authors: Pagliani
authors: Luca
authors: L
authors: Campi
authors: Gian Maria
authors: GM
authors: Cavallini