Filippi Jorge, Quezada Felipe, Lagos Marcela, Patricia García
Departamento de Ortopedia y Traumatología, Pontificia Universidad Católica de Chile.
Rev Med Chil. 2008 Nov;136(11):1448-52. doi: 10.4067/s0034-98872008001100011.
Mycetoma is a chronic infection that affects skin, subcutaneous tissue and bone. Its etiology can be mycotic or bacterial. It affects mainly the lower extremities of middle age men living in tropical climates. We report a 44-year-old male living in a template zone, consulting for swelling and pain in the left foot, lasting for 10 years. Physical examination showed a swollen left foot with hyperpigmented skin and a few crusted papules. Radiology showed an extensive bone involvement of the midfoot with several oval and radiolucid images. Magnetic resonance showed soft and bone tissue involvement, with multiple oval and low intensity images in T1 and T2. The biopsy was compatible with an unspecific chronic osteomyelitis. A bacterial identiFcation by polymerase chain reaction and sequencing in the biopsy determined the presence of an Actinomadumra madurae. Treatment with cotrimaxazol was started.
足菌肿是一种影响皮肤、皮下组织和骨骼的慢性感染。其病因可以是真菌性或细菌性的。它主要影响生活在热带气候地区的中年男性的下肢。我们报告一例44岁居住在温带地区的男性,因左脚肿胀和疼痛就诊,症状持续10年。体格检查显示左脚肿胀,皮肤色素沉着,有一些结痂丘疹。放射学检查显示中足广泛骨质受累,有多个椭圆形透亮影像。磁共振成像显示软组织和骨质均受累,在T1和T2加权像上有多个椭圆形低信号影像。活检结果符合非特异性慢性骨髓炎。通过聚合酶链反应和活检组织测序进行细菌鉴定,确定存在马杜拉放线菌。开始使用复方新诺明进行治疗。