Jerez Richard, Schafer Fabiola, Fich Félix, García Patricia, León Pilar, González Sergio
Departamento de Dermatología, Pontificia Universidad Católica de Chile, Chile.
Rev Chilena Infectol. 2012 Aug;29(4):459-63. doi: 10.4067/S0716-10182012000400018.
Mycetoma is a chronic, granulomatous, subcutaneous, inflammatory lesion caused by true fungi (eumycetoma) or filamentous bacteria (actinomycetoma). Mycetoma commonly affects young people between 20 and 40 years old. The most common affected site is the foot. The characteristic clinical triad is tumefaction, draining sinuses and discharging grains. We report a healthy 31-year-old male, with a 6-year history of a progressive inflammatory tumor associated with sinus tracts and granules on his left sole. Actinomycetoma was suspected. The clinical diagnosis was confirmed by microbiological and histopathological study. Polymerase chain reaction and DNA sequencing identified Actinomadura madurae. To our knowledge, this is the second case of mycetoma reported in Chile. Our report emphasizes the need to consider this diagnosis in patients with chronic granulomatous disease associated with sinus tracts, fistulas and grains.
足菌肿是一种由真性真菌(真菌性足菌肿)或丝状细菌(放线菌性足菌肿)引起的慢性、肉芽肿性、皮下炎症性病变。足菌肿常见于20至40岁的年轻人。最常受累的部位是足部。其特征性的临床三联征是肿胀、引流窦道和排出颗粒。我们报告一例31岁健康男性,有6年的左足底进行性炎性肿瘤病史,伴有窦道和颗粒。怀疑为放线菌性足菌肿。微生物学和组织病理学研究证实了临床诊断。聚合酶链反应和DNA测序鉴定为马杜拉放线菌。据我们所知,这是智利报告的第二例足菌肿病例。我们的报告强调,对于伴有窦道、瘘管和颗粒的慢性肉芽肿性疾病患者,需要考虑这一诊断。