Abstract

During the COVID pandemic, a 45-year male was admitted with complaints of painful swelling over forehead for 3 days. He presented with massive swelling with multiple discharging sinuses over forehead. The patient was initially suspected as a case of mucormycosis & was treated with IV Amphotericin with no clinical improvement. CT orbit- Orbital preseptal cellulitis, subperiosteal abscess, B/L frontal maxillary& ethmoid sinusitis. Pus sent for gram staining showed thin basophilic bacterial filament along with extensive necrosis with sulfur granules suggestive of actinomycosis.
He was treated with IV Penicillin G 200,000U/kg/day for 4 weeks followed by oral Penicillin V (4g/day) for 2 months. The patient responded well to treatment. He was discharged with BCVA 6/9 & was advised to continue oral penicillin for 6 more months to prevent relapse.