Spinal epidural abscess due to Actinomyces israelii

A 31-year-old man had back pain, weight loss, fever, and paraplegia, with radiographic evidence of a left upper lobe lesion and lytic lesions in ribs and vertebral bodies. Gallium uptake was increased over the spine. At surgery we found a paraspinal abscess due to Actinomyces israelii. The patient responded to surgery and penicillin therapy. This is the first report of a case of actinomycotic spinal epidural abscess necessitating emergency surgery since the advent of penicillin.