Boushabi Ayoub, Hicham Aitbenali, Mohamed Shimi
CHU Mohammed VI Tangier, Department of Orthopedic Traumatology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaydi University, Moracco.
CHU Mohammed VI Tangier, Department of Orthopedic Traumatology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaydi University, Moracco.
Int J Surg Case Rep. 2023 Dec;113:109052. doi: 10.1016/j.ijscr.2023.109052. Epub 2023 Nov 13.
Actinomycosis of the foot is a rare, chronic, granulomatous infectious ailment affecting the skin, dermis, and subcutaneous tissues. It is caused by a fungal or actinomycotic agent, resulting in a pseudotumoral appearance. This pathology typically progresses slowly, leading to delayed diagnosis. The primary objective of this report is to emphasize the rarity and clinical significance of this highly uncommon medical condition.
We present the case of a 45-year-old woman with a mass on the sole of her right foot. The condition was treated through excisional biopsy along with combined antibiotic therapy. Histopathology of the excised mass confirmed the presence of actinomycosis, ultimately confirming the diagnosis. The patient's progress was satisfactory, with no recurrence observed over a 2-year follow-up period.
Actinomycosis of the foot is a common pathology in tropical and subtropical regions where climatic conditions promote its emergence. It is a chronic, granulomatous infection of exogenous origin, caused by either fungal (eumycetoma) or bacterial (actinomycetoma) agents. When left unrecognized, these infections can lead to complications, including osteoarticular lesions, with a severe impact on the functional prognosis. The presence of foot swelling should raise suspicion of mycetoma as a diagnosis, with confirmation relying on histological analysis. Management typically involves the aggressive control of invasive soft-tissue masses, often followed by prolonged antibiotic treatment. Skin grafting is a standard method for closing Madura foot defects, and continuous surveillance is necessary due to the potential for actinomycosis recurrence.
In the context of Morocco, actinomycosis of the foot remains sporadic. Identifying these conditions presents significant diagnostic challenges, leading to unfortunate treatment delays. These largely unrecognized conditions have the potential to become more complex by causing osteoarticular damage and lesions, ultimately worsening the functional outlook. Early vigilance is advisable upon observing foot swelling, considering the possibility of actinomycosis of the foot. A definitive diagnosis requires histological analysis, a critical step.
足部放线菌病是一种罕见的慢性肉芽肿性感染性疾病，累及皮肤、真皮和皮下组织。它由真菌或放线菌病原体引起，导致假瘤样外观。这种病理情况通常进展缓慢，导致诊断延迟。本报告的主要目的是强调这种极为罕见的医学病症的罕见性和临床意义。
我们报告一例45岁女性，其右足底有一肿块。该病症通过切除活检及联合抗生素治疗。切除肿块的组织病理学检查证实存在放线菌病，最终确诊。患者病情进展令人满意，在2年随访期内未观察到复发。
足部放线菌病在热带和亚热带地区是一种常见的病理情况，那里的气候条件促使其出现。它是一种外源性慢性肉芽肿性感染，由真菌（足菌肿）或细菌（放线菌性足菌肿）病原体引起。如果未被识别，这些感染可导致并发症，包括骨关节病变，对功能预后有严重影响。足部肿胀的出现应引起对足菌肿诊断的怀疑，确诊依赖于组织学分析。治疗通常包括积极控制侵袭性软组织肿块，随后常进行长期抗生素治疗。皮肤移植是闭合马杜拉足缺损的标准方法，由于放线菌病有复发的可能性，持续监测是必要的。
在摩洛哥，足部放线菌病仍然散发。识别这些病症存在重大诊断挑战，导致不幸的治疗延迟。这些很大程度上未被认识的病症有可能因引起骨关节损伤和病变而变得更加复杂，最终使功能前景恶化。观察到足部肿胀时建议尽早保持警惕，考虑足部放线菌病的可能性。明确诊断需要组织学分析，这是关键步骤。
