tetracycline and Mycetoma

Twenty seven cases of actionomycotic mycetoma caused either by Actinomadura madurae or Actinomadura pelletierii have been described. Infection by A. madurae has been more common than A. pelletierii. Left foot in A. madurae and right foot in A. pelletierii infections were involved more commonly in adult males, whereas right foot of the females was frequently affected in A. madurae infection. Large, soft, white grains in A. madurae and small, firm, red grains in A. pelletierii were consistently seen. Deep hematoxylin stained grains with scalloped margin and prominent eosinophilic club in A. madurae and such deep stained grains with smooth margin and horizontal cracks appearing as portions of a spherical mass in A. pelletierri were diagnostic. Large numbers of plasma cells and Russel bodies were also characteristic of A. madurae infection. Both the grains were stainable with Von Kossa method for calcium. Bone changes were similar in both the infections. Oral tetracycline produced soft tissue and bone resolution to almost normalcy in those who regularly consumed the drug any time from 2 to 6 years. Mild glucose intolerance, facial hyperpigmentation and urticaria were the side effects observed in a few. Two patients developed cataract following tetracycline therapy. The value of medical therapy with oral tetracycline in Actionomadura mycetomas is emphasized.

Topics: Actinomycetales; Adolescent; Adult; Aged; Female; Foot Dermatoses; Humans; Male; Middle Aged; Mycetoma; Radiography; Tetracycline

A second case of actinomycetoma due to Nocardia caviae contracted in Israel is reported. A 39-year-old female of Yemenite origin, resident in Israel for more than 15 years, presented with a sclerotic tumor mass on the dorsum of the right foot which discharged an oily purulent fluid containing minute yellowish granules. Seen in the microscopic examination of smears were thin Gram-positive filaments and bacillary elements. Culture of the crushed granules yielded small pale colonies identified as Nocardia caviae. In vitro testing of the isolate to various antibiotics, isoniaside and sulphonamides showed the organism to be more sensitive to isoniaside and tetracycline. Isoniaside was administered for one year with marked improvement and was then replaced by tetracycline due to side effects, this treatment still being continued.

Topics: Adult; Female; Humans; Isoniazid; Israel; Mycetoma; Nocardia; Tetracycline; Yemen

Two cases of nocardial mycetoma were successfully treated with a mixture of trimethoprim and sulfamethoxazole (Bacterim). The patient in case 1 showed resistance to treatment with antibiotics and sulfamethoxypyridazine, and the causal agent of the disease could not be isolated. In case 2, bone involvement was seen; the causal agent was N asteroides. No adverse effects of the drug occurred in a period of treatment ranging from three to nine months.

Topics: Adult; Drug Combinations; Female; Humans; Male; Mycetoma; Nocardia asteroides; Sulfamethoxazole; Sulfamethoxypyridazine; Tetracycline; Trimethoprim

In a case of actinomycotic mycetoma caused by Streptomyces madurae with extensive destruction of the bone, the foot was saved from amputation by appropriate antibiotic therapy given for a period of 2 1/2 years. Periodic x-ray examinations gave a valuable guide to the progress of the patient. Chemotherapy and antibiotics play an important role in the present day management of mycetoma. Cutaneous amelioration is not the criteria for cure. The bone restoration that occurs much later should be the guide for the duration of therapy.

Topics: Adolescent; Bone Regeneration; Female; Foot Diseases; Humans; Mycetoma; Radiography; Sulfadiazine; Tetracycline

Topics: Adolescent; Adult; Amputation, Surgical; Foot; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Mycetoma; Nocardia; Tetracycline

Topics: Adult; Amphotericin B; Biopsy; Climate; Diagnosis, Differential; Humans; Leg; Male; Mycetoma; Nocardia asteroides; Nocardia Infections; Penicillin G Procaine; Tetracycline; Turkey

Topics: Actinomycosis; Adolescent; Cecal Diseases; Humans; Hydrazines; Ileum; Intestinal Diseases; Male; Mycetoma; Postoperative Care; Streptomycin; Tetracycline

Topics: Chloramphenicol; Dapsone; Ethambutol; Foot Dermatoses; Humans; Male; Middle Aged; Mycetoma; Radiography; Recurrence; Streptomyces; Streptomycin; Tetracycline

Topics: Child; Female; Humans; Kanamycin; Lung Diseases, Fungal; Mandibular Diseases; Mycetoma; Neomycin; Nocardia; Nocardia Infections; Penicillins; Radiography; Sulfadiazine; Tetracycline; Time Factors

Topics: Actinomycosis; Humans; Male; Middle Aged; Mycetoma; Nocardia; Nocardia Infections; Penicillins; Sulfonamides; Tetracycline; Texas

Topics: Actinomyces; Actinomycosis; Actinomycosis, Cervicofacial; Adolescent; Adult; Aged; Female; Humans; Lung Diseases; Male; Middle Aged; Mycetoma; Peritoneal Diseases; Tetracycline