[Surgical treatment of mycetoma located in the face]

The first case described in Mexico, was studied by Cícero in 1900 and 1911 Ocaranza, in Sonora, reports some cases, pointing out that the first known case dates back to 1874. In USA González Ochoa identifies the causative agent of the cases he studied, as the same identified in USA, but he calls attention to the fact that it has already been described under the name of Actinomyces brasiliensis, finally, taxonomically it is included among the nocardias. In Mexico the micetoma is caused in 90% of the cases by Nocardia brasiliensis, and 8% by Streptomysis and other actinomycetos and only in 1.5% it is determined by true fungi. Until the observation of the present case, mycetomas had been reported located or scattered in different places of the human body, except the face. This case is observed in a 24 years old woman patient, of peasant extraction, who presents tumoration of the left hemiface, irregularly oval, 18 x 25 cm. of anfractous surface, with nodes and fistulas that secrete suppuration. The evolution is of seven years duration, and begins after a trauma. The mycologic and histopathologic study, confirms N. brasiliensis as the causative agent. X rays prove that the skull bones are not affected, but the mycosis cause anemia. Specific treatment for anemia is installed with trimetropryn and sulphametoxazol plus sulphone, for a period of six months. A change is made to streptomycin to a total of 40 g. and then this is replaced by isonizasyn, adding to both these drugs alphamatoxipyridazine, for a period of six months and in last months, riprampycin plus sulphone are given; always with bad results.(ABSTRACT TRUNCATED AT 250 WORDS)