{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T14:55:37Z","timestamp":1777647337244,"version":"3.51.4"},"reference-count":17,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2018,4,2]]},"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:p>A 63-year-old man presented with a 2-month history of progressive right-sided exophthalmos, painful ophthalmoplegia and fevers. As more features developed, he was diagnosed with giant cell arteritis, then Tolosa-Hunt syndrome, and transiently responded to corticosteroids. A bland cerebrospinal fluid and highly metabolically active brain (<jats:sup>18<\/jats:sup>F)-fluoro-D-glucose-positron emission tomography suggested lymphoma. Biopsy of the mass showed sulphur granules with Gram-positive filamentous bacteria with <jats:italic>Actinomyces<\/jats:italic>-like colonies. <jats:italic>Actinomyces<\/jats:italic> cavernous sinus infections are rare and indolent. They often mimic non-infective causes including other inflammatory and infiltrative conditions, vascular and neoplastic causes, particularly lymphoma. Clinicians should consider infective cavernous sinus syndromes in people with a fluctuating painful ophthalmoplegia that responds poorly to corticosteroids. The term Tolosa-Hunt syndrome is problematic and should be retired or used only with reservation.<\/jats:p>","DOI":"10.1136\/practneurol-2017-001844","type":"journal-article","created":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T12:21:21Z","timestamp":1523535681000},"page":"373-377","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["<i>Actinomyces<\/i> cavernous sinus infection: a case and systematic literature review"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4990-9293","authenticated-orcid":false,"given":"Michal","family":"Lubomski","sequence":"first","affiliation":[{"name":"Department of Neurology, Concord Repatriation General Hospital, Concord, New South Wales, Australia"},{"name":"School of Medicine, The University of Notre Dame Australia, Sydney, New South Wales, 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