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Disseminated orbital actinomycetoma: a case report
Nita Umesh Shanbhag1, Sumita Karandikar, Pooja Anil Deshmukkh
1D. Y. Patil Medical College and Research Center, Navi Mumbai, India.
Indian Journal of Ophthalmology
|December 24, 2009
Summary
This case highlights actinomycetoma, a chronic infection, unusually affecting the orbit and scalp. Nocardia infection led to eyelid swelling and eye dystopia in a young male.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Ophthalmology
Background:
- Mycetoma is a chronic granulomatous infection typically affecting the lower extremities.
- Actinomycetoma is a specific form of mycetoma caused by bacteria of the genus Actinomyces or Nocardia.
Observation:
- A 20-year-old male presented with a year-long history of scalp sinuses and left eyelid swelling with dystopia.
- Clinical examination revealed a 2 mm relative proptosis of the left eye.
- Imaging studies (CT and MRI) confirmed soft tissue swelling, orbital involvement, and increased orbital volume with dystopia.
Findings:
- Microbiology of scalp and eyelid lesions identified the genus Nocardia.
- Diagnosis of actinomycetoma was established based on clinical presentation and microbiological findings.
- The case demonstrates an atypical presentation of actinomycetoma with orbital and cranial involvement.
Implications:
- This case underscores the importance of considering mycetoma in the differential diagnosis of chronic scalp and orbital infections.
- Unusual presentations of actinomycetoma require thorough investigation, including advanced imaging and microbiological analysis.
- Early and accurate diagnosis is crucial for effective management and preventing complications in orbital mycetoma.
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