[Combined cefotaxime and amikacin for immunomodulation in the treatment of actinomycetoma resistant to conventional treatment].
Actinomycetoma is a chronic disease that affects subcutaneous tissue. We present a case of a patient with abdominal actinomycetoma caused by Nocardia brasiliensis resistant to different treatments over several years, who also presented phagocyte immunodeficiency. He received two cycles (23 day cycles) of cefotaxime, 1 g every 8-h, and amikacin, 500 mg every 12 hours. Immunomodulation was carried out with levamisole 300 mg per week, during 4 weeks and bacterial antigen (at a concentration of 600,000,000 bacteria per mL), twice for a week during 20 months. The importance of susceptibility testing and immunological function investigation in this type of patients is discussed.
Méndez-Tovar
L J
LJ
Servicio de Dermatología y Micología Médica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, MSS, México D.F.
Serrano-Jaén
L
L
Almeida-Arvizu
V M
VM
D000009:Abdominal Muscles; D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D000583:Amikacin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002439:Cefotaxime / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D002908:Chronic Disease; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008271:Mycetoma / Q000188:drug therapy; D009617:Nocardia Infections / Q000188:drug therapy*
D000276:Adjuvants, Immunologic; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000583:Amikacin; D002439:Cefotaxime
Cefotaxima más amikacina asociadas a inmunomodulación en el tratamiento de actinomicetoma resistente a tratamiento convencional.