Actinomyces infection in porous polyethylene orbital implant

Background: A 60-year-old patient developed actinomycotic inflammation within a porous polyethylene orbital implant which she received following enucleation. Methods: She had repeated conjunctival exposures with inflammation the primary implant was removed and replaced with another one. Results: The anterior two-thirds of the porous implant was infiltrated with numerous actinomycotic granules surrounded by polymorphonuclear cells and necrotic debris. The organisms were demonstrated with Gram stains on the histopathologic preparations and with scanning electron microscopy. Within the zones of inflammation, the polyethylene skeleton of the implant was extensively damaged. Conclusion: Actinomycetes have been described as causative organisms in conjunctivitis, blepharitis, canaliculitis, dacryocystitis and keratitis, but to the best of our knowledge actinomycotic involvement has never been reported in an infected porous orbital implant.