Actinomycetoma-recurrence after amputation

Abstract

Actinomycetoma is a chronic granulomatous infection of the subcutaneous tissue caused by fungus-like bacteria, that is, Nocardia sp, Actinomyces sp. This infection is common in tropical countries like India, though the disease is worldwide in distribution. A 22-year-old female who presented with multiple fistulas, sinus tracts, and pain and swelling over left foot following trauma 6 years back. A diagnosis of actinomycetoma was made based on clinical and microbiological ground. Two years after amputation there was recurrence and finally took multiple antibiotic therapies but was left without cure. Another case was that of a 37- year-old male who presented with multiple fistulas, sinus tracts, and pain and swelling on the right sole 6 months after prick of bamboo stick. There was a recurrence after amputation. Both the patients were treated with a Wallace regimen (Amikacin with Cotrimoxazole/Minocycline/Ciprofloxacin). Patient showed excellent response with healing of all sinuses after 2 months of therapy.