Pérez-Blanco M, Hernández-Valles R, Fernández-Zeppenfeldt G, Yegres F
Centro de Investigaciones Biomédicas, Universidad Nacional Experimental Francisco de Miranda, Coro, Estado Falcón, Venezuela.
Invest Clin. 1996 Mar;37(1):61-73.
This is a report of three cases of mycetome studied in our laboratory during the last four years. We also informed about the evolution of the first case produced by Pyrenochaeta romeroi nova species reported by Borelli in 1959. All the patients were farmer men, 18, 42 and 54 years old, from the semiarid and subhumid zones of Falcon State, located on the northwest region of Venezuela. Clinically, all patients presented the mycetome syndrome (subcutaneous edema, sinus tract and "granules"), with a evolution of six months to three years. The lesions were localized in the inferior limbs in two of the patients and in the thorax in one of them. The clinical diagnose was confirmed by microbiological and mycological studies, isolating Nocardia brasiliensis in two cases and Madurella grisea in one. Two patients treated with Sulfas showed remission of the disease in a two years follow up. Including this report, 15 cases of mycetome have been reported in the Falcon State (Venezuela) in a period of thirty five years, representing only 9, 14% of the national casuistic. Actinomadura madurae and N. brasiliensis have been the most frequently isolated agents in this region. In order to determine the real endemicity of the mycetome in Venezuela, multidisciplinary clinical, inmunological, microbiological and epidemiological studies are recommended. According to the reported casuistic (15 cases), the mycetome should be a low frequency disease in Falcon State, Venezuela. We confirm that early diagnosis favors an efficient therapy.
这是一份关于过去四年在我们实验室研究的三例足菌肿病例的报告。我们还通报了1959年博雷利报告的由罗梅罗拟茎点霉新物种引起的首例病例的病情发展情况。所有患者均为男性农民，年龄分别为18岁、42岁和54岁，来自委内瑞拉西北部法尔孔州的半干旱和亚湿润地区。临床上，所有患者均表现出足菌肿综合征（皮下水肿、窦道和“颗粒”），病程为6个月至3年。其中两名患者的病变位于下肢，一名患者的病变位于胸部。微生物学和真菌学研究证实了临床诊断，两例分离出巴西诺卡菌，一例分离出灰马杜拉放线菌。两名接受磺胺治疗的患者在两年的随访中病情缓解。包括本报告在内，35年间委内瑞拉法尔孔州共报告了15例足菌肿病例，仅占全国病例的9.14%。马杜拉马杜拉放线菌和巴西诺卡菌是该地区最常分离出的病原体。为了确定委内瑞拉足菌肿的实际流行情况，建议开展多学科的临床、免疫学、微生物学和流行病学研究。根据报告的病例数（15例），足菌肿在委内瑞拉法尔孔州应是一种低发疾病。我们证实早期诊断有利于有效治疗。
