[Mycetoma: attempt at intra-arterial management].

A 28 year old African student had acquired a mycetoma of his left foot after an injury in 1975. As the surgical and antimycotic therapy had no effect, he was brought to Düsseldorf for the amputation of his foot. Madurella mycetomi was isolated from the skin, pus and bone. Before the amputation was made a last attempt to treat him with the antimycotic agent miconasol nitrate, administered intraarterially through the arteria tibialis posterior, which had been shown i arteriography to perfuse the whole foot. On the 23rd day of therapy pain and fever indicated bacterial infection. The fungus could still be isolated from the bone tissue. The therapy was terminated on the 30th day. The catheter was blocked and amputation of the food became inevitable. The patient received an artificial limb and is able to move freely. In similar cases of mycotic bone infection an attempt with intraarterial infusion of an antimycotic agent should be made immediately.