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Actinomycetoma in the United States
Reviews of Infectious Diseases
|November 1, 1981
Summary
Actinomycetoma, a Madura foot infection, was treated successfully with trimethoprim-sulfamethoxazole (TMP-SMZ) in an Indiana case. This highlights TMP-SMZ
Area of Science:
- Medical Mycology
- Infectious Diseases
- Antimicrobial Therapy
Background:
- Actinomycetoma, also known as Madura foot, is a chronic granulomatous infection.
- It is caused by aerobic actinomycetes, with Actinomadura madurae being a common etiological agent.
- Previous studies have documented various treatment regimens for actinomycetoma.
Observation:
- A case of actinomycetoma caused by Actinomadura madurae in an Indiana factory worker is presented.
- The patient received treatment with trimethoprim-sulfamethoxazole (TMP-SMZ).
- Sulfadiazine therapy was ineffective in this case.
Findings:
- Trimethoprim-sulfamethoxazole (TMP-SMZ) therapy proved effective in treating the patient's actinomycetoma.
- In vitro susceptibility testing indicated that sulfamethoxazole (SMZ) was significantly more active against the A. madurae strain than sulfadiazine.
- Trimethoprim (TMP) showed no in vitro activity, suggesting SMZ alone may have been responsible for the treatment success.
Implications:
- Effective antimicrobial therapy, such as TMP-SMZ, can successfully manage actinomycetoma.
- Antimicrobial susceptibility testing is crucial for guiding treatment decisions.
- Prompt and appropriate medical management can often prevent the need for surgical intervention, including amputation.