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

Title
Actinomycetoma in SE Asia: the first case from Laos and a review of the literature
Authors
Rattanavong, S; Vongthongchit, S; Bounphamala, K; Vongphakdy, P; Gubler, J; Mayxay, M; Phetsouvanh, R; Elliott, I; Logan, J; Hill, R; Newton, PN; Dance, D
Keywords
Mycetoma, Madura foot, Actinomadura madurae, Lao PDR, Laos, Southeast Asia
Issue Date
2012
Publisher
BIOMED CENTRAL LTD
Citation
BMC INFECTIOUS DISEASES; Vol.12
Abstract
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.
URI
http://hdl.handle.net/11267/2065
ISSN
1471-2334
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3.University of Health Sciences > Faculty of postgraduate > Others
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