[Cervical actinomycosis starting as a monoparesis of the upper left extremity]

We present a case of cervical actinomycosis which due to its localization, unusually low and posterior, made its debut as a monoparesis and which due to its unexpected size, marked aggressiveness, and radiologic image mimicked a tumor. We have not found in the literature this kind of presentation up to date. Although sulphur grains were not observed, empiric treatment could be started based on the Gram stain information. Culture was delayed 15 days, but we could promptly obtain reliable diagnosis thanks to pathologic study. Associated Pseudomonas aeruginosa was isolated.