Ndiaye B, Develoux M, Langlade M A, Kane A
Clinique Dermatologique, Hôpital Le Dantec, Dakar, Sénégal.
Ann Dermatol Venereol. 1994;121(2):161-5.
Actinomycotic mycetoma is frequent in Senegal and the treatment has changed greatly over the last decades. We observed 27 cases due to Actinomadura pelletieri (n = 21), Actinomadura madurae (n = 5) and Streptomyces somaliensis (n = 1). The diagnosis was based on clinical and histological arguments. All the patients were treated with cotrimoxazole for several months. The mycetoma was situated on the foot in 15/27 patients. Extrapodal localizations were frequent for red grains due to A. pelletieri (11/21). These mycetomas, the most frequent in Senegal, are extremely severe lesions with rapid local and distance extension. We were able to obtain 8 clinical cures. One death occurred in patient with an abdominal localization and multiorgan invasion. Mid-term outcome could not be determined in the other cases since they were lost to follow-up after initial improvement with cotrimoxazole. As sole treatment, cotrimoxazole should lead to cure in most cases.
放线菌性足菌肿在塞内加尔很常见，在过去几十年里治疗方法有了很大变化。我们观察了27例由佩氏马杜拉放线菌（n = 21）、马杜拉马杜拉放线菌（n = 5）和索马里链霉菌（n = 1）引起的病例。诊断基于临床和组织学依据。所有患者均接受了数月的复方新诺明治疗。27例患者中有15例足部患有足菌肿。由佩氏马杜拉放线菌引起的红色颗粒型足菌肿（11/21）常发生于足部以外的部位。这些足菌肿是塞内加尔最常见的，是极其严重的病变，会迅速局部蔓延和远处扩散。我们成功治愈了8例患者。1例腹部受累并伴有多器官侵袭的患者死亡。由于其他病例在接受复方新诺明初始治疗改善后失访，因此无法确定其中期预后。作为唯一的治疗方法，复方新诺明在大多数情况下应能治愈。
