trimethoprim--sulfamethoxazole-drug-combination and Osteolysis

Mycetoma is a bacteriological or fungal infectious disease affecting the skin and/or soft tissues, which can be complicated by bone involvement. The most common feature is a tumor of the foot, but extrapodal localizations have been described. We report one case of a 47-year-old man who presented with tumefaction of a leg with multiple skin fistulae. Histopathological examination permitted to confirm the diagnosis of actinomycetoma and TDM showed the degree of bone and soft tissues involvement. Our case was characterized by the very inflammatory aspect of the tumor, its localization to the leg without foot involvement, the modest functional signs compared to the importance of radiological bone involvements, the deep destruction of the fibula while the tibia was apparently intact and the good response to treatment. In spite of its characteristic features, diagnosis of mycetoma is still late in our country, often with bone and/or articular spread. Priority may be given to measures for reduction of mycetoma diagnosis lateness.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Bone Diseases, Infectious; Cutaneous Fistula; Delayed Diagnosis; Diclofenac; Humans; Leg; Male; Middle Aged; Mycetoma; Osteolysis; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

We report the successful treatment of disseminated Mycobacterium intracellulare osteomyelitis, without evidence of other visceral involvement, in a previously healthy, HIV-negative, 2-year-old female using a 23-month regimen of antimicrobial agents that included 18 months of oral therapy with azithromycin, rifabutin, trimethoprim-sulfamethoxazole (TMP/SMX), and ethambutol.

Topics: Azithromycin; Child, Preschool; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; HIV Seronegativity; Humans; Immunocompetence; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Osteolysis; Osteomyelitis; Rifabutin; Trimethoprim, Sulfamethoxazole Drug Combination