Actinomycetoma in SE Asia: the first case from Laos and a review of the literature

BMC Infectious Diseases

David Dance⁷  Paul N Newton⁷  Robert Hill¹  Julie Logan⁶  Ivo Elliott⁷  Rattanaphone Phetsouvanh⁷  Mayfong Mayxay⁷  Jacques Gubler⁴  Phouvong Vongphakdy⁵  Khamhou Bounphamala²  Sivay Vongthongchit²  Sayaphet Rattanavong³ 

[1] Antibiotic Resistance Monitoring & Reference Laboratory (ARMRL), Health Protection Agency Microbiology Services Colindale, 61 Colindale Avenue, London, NW9 5EQ, UK;Surgery Unit, Xiengkhuang Provincial Hospital, Xiengkhuang, Lao PDR;Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR;Department of Medicine, Infectious Diseases, Kantonsspital, Winterthur, Switzerland;General Surgery Department, Mahosot Hospital, Vientiane, Lao PDR;Department for Bioanalysis and Horizon Technologies, Health Protection Agency Microbiology Services Colindale, 61 Colindale Avenue, London, NW9 5HT, UK;Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, OX3 7LJ, UK

关键词: Southeast Asia;    Laos;    Lao PDR;    Actinomadura madurae;    Madura foot;    Mycetoma;   

Others  :  1158711
DOI  :  10.1186/1471-2334-12-349

 received in 2012-08-15, accepted in 2012-12-10,  发布年份 2012

【 摘 要 】

Background

Mycetoma is a chronic, localized, slowly progressing infection of the cutaneous and subcutaneous tissues caused either by fungi (eumycetoma or implantation mycosis) or by aerobic actinomycetes (actinomycetoma). It is acquired by traumatic implantation, most commonly in the tropics and subtropics, especially in rural agricultural communities. Although well recognized elsewhere in Asia, it has not been reported from the Lao People’s Democratic Republic (Laos).

Case presentation

A 30 year-old female elementary school teacher and rice farmer from northeast Laos was admitted to Mahosot Hospital, Vientiane, with a massive growth on her left foot, without a history of trauma. The swelling had progressed slowly but painlessly over 5 years and multiple draining sinuses had developed. Ten days before admission the foot had increased considerably in size and became very painful, with multiple sinuses and discharge, preventing her from walking. Gram stain and bacterial culture of tissue biopsies revealed a branching filamentous Gram-positive bacterium that was subsequently identified as Actinomadura madurae by 16S rRNA gene amplification and sequencing. She was treated with long-term co-trimoxazole and multiple 3-week cycles of amikacin with a good therapeutic response.

Conclusion

We report the first patient with actinomycetoma from Laos. The disease should be considered in the differential diagnosis of chronic skin and bone infections in patients from rural SE Asia.

【 授权许可】

   
2012 Rattanavong et al.; licensee BioMed Central Ltd.

【 图 表 】

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