Pagliani Livio, Campi Luca, Cavallini Gian Maria
Dipartimento Misto di Neuroscienze, Testa, Collo e Riabilitazione, Università degli Studi di Modena e Reggio Emilia, Struttura Complessa di Oftalmologia, Modena, Italia.
Ophthalmologica. 2006;220(3):201-5. doi: 10.1159/000091767.
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.
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.
Prolonged antibiotic therapy with synthetic penicillin completely resolved the case.
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.
评估一例有肾癌和乳腺癌病史的患者表现为托洛萨-亨特综合征的眼眶放线菌病病例。
一名患有进行性疼痛性眼肌麻痹的女性前来接受我们的观察。脑部、眼眶和全身CT扫描显示存在两个眼眶新生物以及肺部的粟粒状播散模式。最初诊断指向先前肾和乳腺肿瘤的继发性定位，在对肺活检样本进行微生物分析后，诊断改为眼眶和肺部放线菌病。
使用合成青霉素进行长期抗生素治疗使该病例完全康复。
放线菌病是一种非常罕见的感染，也可能影响眼眶，其与肺部播散的关联非常罕见。在疼痛性眼肌麻痹的病因中考虑这种类型的感染很重要。
