rifampin and Mycetoma

AbstractMycetoma is a chronic soft tissue infection caused by fungal or bacterial pathogens, and is endemic in tropical and subtropical regions. Cases in developed countries outside the mycetoma belt are rare and usually imported by immigrants. Sporadic cases have been reported in Israel. Unpublished cases in the participating medical centers are reported. In addition, a systematic review of the literature was performed. All published mycetoma cases diagnosed in Israel were included with relevant variables collected. Twenty-one cases of mycetoma were diagnosed in Israel between 1942 and 2015, including four unpublished cases and 17 published cases. The mean age at diagnosis was 42 years (range 23-73), and 16 of the patients were male. The foot was the primary involved organ. Fifteen patients were immigrants from Yemen, Ethiopia, and Sudan. Five cases were autochthonous. One case was travel related. Among patients who developed symptoms after immigration, the mean time from exposure to symptom onset was 5.6 years (range 1-10 years). The mean time from symptom onset to diagnosis was 6.6 years (range 0.2-35 years). The autochthonous cases demonstrate that Israel is endemic of mycetoma. The immigrant population represents two distinct waves of immigration to Israel in the past century. Two unpublished cases of Ethiopian immigrants are the first reported cases of mycetoma acquired in Ethiopia. The diagnostic and therapeutic challenges along with the epidemiological data emphasize the need of raising the awareness of physicians to this devastating condition even in developed countries.

Topics: Adult; Amikacin; Anti-Infective Agents; Databases, Factual; Emigrants and Immigrants; Ethiopia; Female; Follow-Up Studies; Humans; Israel; Male; Middle Aged; Mycetoma; Rifampin; Sudan; Sulfamethoxazole; Treatment Outcome; Trimethoprim; Yemen; Young Adult

The association sarcoidosis-lung abscess due to emerging microorganisms-mycetoma has prompted the authors to report the above clinical case which is interesting in view of the rarity of the disease and of its infective complications. The authors also review the literature on the subject.

Topics: Bronchoalveolar Lavage Fluid; Ceftazidime; Fluconazole; Humans; Lung Abscess; Male; Middle Aged; Mycetoma; Radiography, Thoracic; Rifampin; Sarcoidosis; Tomography, X-Ray Computed

Mycetoma has a worldwide geographical distribution which is extremely uneven; however, it is a common disease in India and responsible for causing significant morbidity. Treatment of this condition is often a challenge for the treating dermatologist. The authors report a promising therapy for patients of actinomycotic mycetoma.. This assessment series included 18 patients with a confirmed diagnosis of actinomycetoma, and who had shown a poor response to previous treatments. Patient received a combination therapy of the Welsh regimen (amikacin along with cotrimoxazole) to which rifampicin was added as a third drug. Clinical evaluation included radiology and laboratory investigations.. Sixteen patients out of 18 completed the combination therapy, which lead to remission. Two patients were lost to follow-up. Of the 16 patients in remission, no recurrence was observed during a follow-up period of up to 18 months.

Topics: Adult; Amikacin; Anti-Bacterial Agents; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mycetoma; Prospective Studies; Remission Induction; Rifampin; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Actinomycetoma is a chronic granulomatous disease affecting skin, subcutaneous tissue, fascia, muscle and bones. With increasing resistance against commonly used treatment regimens, susceptibility testing is urgently needed.. We developed an in vitro susceptibility assay for Actinomadura madurae, one of the common causative agents of actinomycetoma, employing resazurin for endpoint reading. Using this assay, reproducible MICs were determined for the most commonly used antibacterial agents for actinomycetoma treatment. The tested antibacterial agents included trimethoprim/sulfamethoxazole, amikacin, streptomycin, amoxicillin, ceftriaxone, gentamicin, ciprofloxacin, doxycycline, imipenem, linezolid, penicillin G and rifampicin.. Following the clinical breakpoints as stated by CLSI, 100% of the tested strains were susceptible to trimethoprim/sulfamethoxazole (MIC 0.03/0.59-1/19 mg/L), amikacin (MIC 0.0078-0.25 mg/L), doxycycline (MIC <0.25-1 mg/L) and linezolid (MIC <0.25-2 mg/L), 90% to ciprofloxacin (MIC <0.25-2 mg/L), 80% to ceftriaxone (MIC <0.5 to >64 mg/L) and imipenem (MIC <0.25-32 mg/L) and only 20% to amoxicillin (MIC <0.5 to >64 mg/L) and rifampicin (MIC 0.5 to >32 mg/L).. Determinations of MICs by visual readings of colour changes versus spectrophotometric readings were comparable. This convenient visual reading has the advantage of feasible implementation in endemic settings.

Topics: Amikacin; Amoxicillin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Doxycycline; Humans; Ifosfamide; Imipenem; Linezolid; Microbial Sensitivity Tests; Mycetoma; Rifampin; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Actinomyces; Adult; Anti-Bacterial Agents; Drug Therapy, Combination; Humans; Male; Mycetoma; Penicillin G Benzathine; Rifampin; Skin Ulcer; Trimethoprim, Sulfamethoxazole Drug Combination

A 45-year-old male presented with history of multiple swellings over the foot with sinuses discharging seropurulent pus. Actinomadura madurae was demonstrated and identified by microbiological culture from the pus obtained directly of the lesion. This case is reported to emphasize the importance of laboratory diagnosis in the management and assessment of the prognosis of such cases.

Topics: Actinomycetales; Anti-Infective Agents; Dapsone; Drug Therapy, Combination; Foot Dermatoses; Gentian Violet; Humans; India; Male; Middle Aged; Mycetoma; Phenazines; Rifampin; Suppuration; Trimethoprim, Sulfamethoxazole Drug Combination