Introduction: We report the case of a patient suffering from disseminated actinomycosis.
Case report: A fifty-two year old man, who was both a heavy smoker and an alcoholic, was admitted to hospital with confusion associated with a pseudo-tumoral right upper lobe pneumonia. Brain computed tomography was normal on the day of admission but when repeated fifteen days later four lesions were seen with appearances suspicious of metastatic malignant disease. The isolation of Actinomyces odontolyticus in the bronchoalveolar lavage culture and the absence of evidence for neoplastic disease despite extensive investigation led to a diagnosis of disseminated actinomycosis with pulmonary and cerebral involvement. The patient's clinical condition improved with antibiotic therapy. The disseminated form of this infection as well as presentation with multifocal brain abscesses is rare.
Conclusion: The diagnosis of actinomycosis is problematic because it is an uncommon infection and microbiological identification is often difficult and delayed. It should be considered when clinical presentation suggests malignant disease but there is no histological confirmation.