Abstract:
Mycetoma is a chronic infection of underlying fungal (eumycetoma) or bacterial (actinomycetoma) origin. It is characterised by a clinical triad of tumour-like swelling, actively draining sinuses and macroscopic grains of characteristic colours.We the case of a 66-year-old woman on immunosuppressive therapy presenting with eumycetoma of the foot (Madura foot). The fungal organism cultured was Acrophialophora fusisporaThis case was managed with a combination of extensive surgical debridement, and packing with calcium sulfate (Stimulan) beads impregnated with vancomycin and voriconazole. As far as the authors are aware, this is a novel adjunct to the surgical treatment of deep fungal infection in the foot.Eumycetoma treated with surgery and oral antifungal therapy leads to cure rates of 25%-35%. This novel treatment seems to bear further investigation for the potential to improve cure rates. At 8 months follow-up, our patient appears to be making good progress with no current signs of recurrence.
摘要:
真菌瘤是潜在真菌(真菌瘤)或细菌(放线菌瘤)起源的慢性感染。它的特征是肿瘤样肿胀的临床三联症,积极排水鼻窦和宏观颗粒的特征颜色。我们以一名接受免疫抑制治疗的66岁妇女为例,该妇女表现为足部大肿(Madurafoot)。培养的真菌是Acrophialophorafusispora该病例采用广泛的手术清创术治疗,并用万古霉素和伏立康唑浸渍的硫酸钙(Stimulan)珠包装。据作者所知,这是足部深部真菌感染手术治疗的新辅助手段。通过手术和口服抗真菌药物治疗的Eumycetoma治愈率为25%-35%。这种新颖的治疗方法似乎需要进一步研究提高治愈率的潜力。在8个月的随访中,我们的患者似乎进展良好,目前没有复发迹象.