The Madura foot: an "innocent foot mycosis"?
With the increased movement of the world population, acquaintance with the clinical picture of the Madura foot is of growing importance beyond its original endemic areas. The characteristic triad of symptoms consists of indurated swelling, multiple sinus tracts with purulent discharge filled with grains and localization at the foot. An increasing number of new etiologic agents are recognized today. For a better choice of therapy an adequate diagnostic procedure is essential ; a deep biopsy for histology appears to give a more substantial contribution to identification of the causal organism than culture. The treatment which should be started early, is at first essentially a drug treatment. However, in spite of high expectations with regard to new antimycotic drugs, amputation or disarticulation is often inevitable even today, particularly when the lesion is caused by Eumycetes. The first two documented patients with this disease in the Netherlands are described. They developed serious deformities of the lower extremity despite long-term use of antimycotic and antibiotic medication.
Department of Orthopedic Surgery, University Hospital Maastricht, The Netherlands.
R
R
Ten Broeke
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G
Walenkamp
D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D017577:Cutaneous Fistula / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D019353:Endemic Diseases; D005531:Foot Deformities, Acquired / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D005534:Foot Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D014943:Global Health; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007654:Ketoconazole / Q000627:therapeutic use; D008297:Male; D008271:Mycetoma / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D009426:Netherlands; D013492:Suppuration; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000935:Antifungal Agents; D017964:Itraconazole; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D007654:Ketoconazole