[Actinomycotic mycetoma. Apropos of 27 cases in Dakar; medical treatment with cotrimoxazole].
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.
Clinique Dermatologique, Hôpital Le Dantec, Dakar, Sénégal.
B
B
Ndiaye
M
M
Develoux
M A
MA
Langlade
A
A
Kane
D000192:Actinomycetales; D002081:Buttocks; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008271:Mycetoma / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D012675:Senegal; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D015662:Trimethoprim, Sulfamethoxazole Drug Combination
Les mycétomes actinomycosiques. A propos de 27 observations dakaroises, traitement médical par le cotrimoxazole.