Brand-Ad-30-6
 IADVL
Indexed with PubMed and Science Citation Index (E) 
 
Users online: 2909 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
  Search
 
   Next article
   Previous article 
   Table of Contents
  
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
   [PDF Not available] *
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

 
  In this article
   Abstract
   Introduction
   Case Report
   Discussion
   References
   Article Figures

 Article Access Statistics
    Viewed7065    
    Printed94    
    Emailed3    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal

 


 
CASE REPORT
Year : 2000  |  Volume : 66  |  Issue : 6  |  Page : 318-319

Actinomycotic Mycetoma




Correspondence Address:
Alka Dogra


Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 20877116

Rights and PermissionsRights and Permissions

  Abstract 

A case of actinomycotic mycetoma presenting as multiple nodules with sinuses and swelling of left foot of six years duration is being reported. The diagnosis was confirmed histologically.


Keywords: Mycetoma, Actinomycetoma


How to cite this article:
Dogra A, Minocha Y C, Gupta M, Khurana S. Actinomycotic Mycetoma. Indian J Dermatol Venereol Leprol 2000;66:318-9

How to cite this URL:
Dogra A, Minocha Y C, Gupta M, Khurana S. Actinomycotic Mycetoma. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2020 Aug 13];66:318-9. Available from: http://www.ijdvl.com/text.asp?2000/66/6/318/4961



  Introduction Top


Mycetoma is a disease of localized, indolent, deforming swollen lesions and sinuses involving cutaneous and subcutaneous tissues, fascia and bone.[1] It usually occurs on the foot or hand. The disease results from the traumatic implantation of soil organisms into the tissues. The lesions are composed of suppurating abscesses and draining sinuses with the presence of grains which are characteristic of etiologic agents. The etiologic agent can be a variety of bacteria (actinomycotic mycetoma) or fungi (eumycotic mycetoma). In India, actinomycotic mycetoma is more commonly encountered than eumycotic mycetoma. However, the latter accounts for most cases reported from Northern India.[2]


  Case Report Top


A 25-year-old woman presented with multiple nodular lesions with swelling on the left foot of 6 years duration. The lesions were distributed mainly on the planter surface with some extension onto the dorsal surface. The initial lesion was a single nodule, which was followed by the appearance of successive nodules close together. All the nodules showed a reddish discharge. There was no history of trauma. Pain was minimal and the patient had no constitutional symptoms. [Figure - 1]

On examination, the left foot showed swelling and induration. Surface showed multiple nodules with draining sinuses and crusting. The regional lymph nodes were not enlarged. Gross examination of the discharge revealed red granules. Gram stain revealed filamentous structures. Smear for acid fast bacilli was negative. Fungal culture did not yield any growth. Biopsy showed presence of microabscesses in the subcutaneous tissue composed of neutrophils, eosinophils, plasma cells and macrophages. The centre of these collections conatined colonies of actinomycetes. X-ray of the foot was normal. After screening for renal function tests, routine hemogram, G-6- PD activity and audiometry, the patient was started on dapsone 100 mg twice a day and streptomycin 1g 1/M once a day. Wound debridement was done by the surgeons in conjunction with the medical treatment. The patient showed an excellent response in a month's time.


  Discussion Top


Mycetoma as a medical entity was first reported as Madura foot in Madurai, India in 1842.[1] The two categories are actinomycotic mycetoma (actinomycetoma) when the agent is an actinomycete and eumycotic mycetoma (eumycetoma) when a true fungus is involved.

The disease is characterized by formation of aggregates of the causative organisms (grains) within abscesses. The clinical features are essentially the same no matter whether fungus or actinomycete is concerned.[3] The earliest stage is a firm, painless nodule but with time, papules, pustules which break down to form sinuses, appear on skin surface. The whole area becomes hard and swollen often without significant pain.[4] The earliest stage is a firm, painless nodule but with time, papules, pustules which break down to form sinuses, appear on skin surface. The whole area becomes hard and swollen often without significant pain.[4] The disease may extend to the underlying bone. The disease has been reported to respond to dapsone, cotrimoxazole, streptomycin and rifampicin.[5] The present patient was put on dapsone and streptomycin and the patient showed a gratifying response.

 
  References Top

1.Rippon JW. Mycetoma In: Rippon, Medical Mycology. The pathogenic fungi and the pathogenic actinomycetes. 2 nd edition: WB Saunders 1982;79.  Back to cited text no. 1    
2.Venugopal PV, Venugopal T. Deep fungal infections In: Textbook and Atlas of Dermatology 1" edition, edited by Valia RG, Bhalani Publishing House, Bombay, 1994;213.  Back to cited text no. 2    
3.Zaias N, Taplin, Rebell G. Mycetoma. Arch Dermatol 1969; 99: 215-225.  Back to cited text no. 3    
4.Palestine RF, Rogers RS. Diagnosis and treatment of mycetoma. J Am Acad Dermatol 1982;6:107-111.  Back to cited text no. 4    
5.Mahgoub ES. Medical management of mycetoma. WHO Bull 1976;54:303-310.  Back to cited text no. 5    


Figures

[Figure - 1]



 

Top
Print this article  Email this article
Previous article Next article

    

Online since 15th March '04
Published by Wolters Kluwer - Medknow