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Actinomycetoma: dramatic response to modified two-step regimen.

Aparna Palit¹, Shivanna Ragunatha, Arun C Inamadar

¹Department of Dermatology, Venereology and Leprosy, Shri B.M. Patil Medical College, Hospital and Research Center, BLDE University, Bijapur, India.

International Journal of Dermatology

|March 19, 2011

Summary

This summary is machine-generated.

Actinomycetoma is a chronic fungal or bacterial infection. Early combination antimicrobial therapy, including gentamicin and cotrimoxazole, led to complete healing in a chest wall case.

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Area of Science:

Medical Mycology
Infectious Diseases
Dermatology

Background:

Mycetoma is a granulomatous subcutaneous infection caused by fungi or bacteria, prevalent in tropical regions.
It can lead to significant morbidity, with potential bone and rare visceral involvement.
Actinomycetoma, a subtype, often affects covered body parts.

Observation:

A 22-year-old male farmer presented with an 8-month history of discharging sinuses on his chest wall, shoulder, and neck.
Clinical and histopathological diagnosis of actinomycetoma was made, as cultures were negative.
The infection involved covered areas, typical for actinomycetoma.

Findings:

A modified two-step antimicrobial regimen was initiated: intravenous gentamicin and oral cotrimoxazole, followed by oral cotrimoxazole and doxycycline.
The patient demonstrated an excellent response, with complete sinus healing after two months of therapy.
This highlights the effectiveness of early, long-term combination antimicrobial treatment.

Implications:

Prompt and appropriate combination therapy is crucial for successful actinomycetoma management.
Understanding the predilection of actinomycetoma for covered body parts aids in diagnosis.
This case underscores the importance of timely intervention to prevent disease progression and morbidity.