title: Pulse therapy with amikacin and dapsone for the treatment of actinomycotic foot: a case report.
abstract: Actinomycetoma is a chronic disease caused by aerobic actinomycetes and affecting the skin, subcutaneous tissue, and bones. It causes significant morbidity and clinically manifests as abscesses and sinus/fistulae with or without granules. Early diagnosis is based on the color, size, histopathology of the granules; culture and metabolic studies are used for further species differentiation. Although sulfamethoxazole-trimethoprim alone or in combination with dapsone for a variable period of time are used as first line agents for treatment, slow response to the therapy and high relapse rates have led to increasing usage of alternative agents like gentamycin, amikacin and cefotaxime. We report a case of actinomycetoma foot who had complete treatment failure with a sulfamethoxazole-trimethoprim-dapsone combination and was successfully treated with combination therapy of amikacin and dapsone without any side effects.
authors.affiliation: The Department of Dermatology and Sexually Transmitted Diseases, Lady Hardinge Medical College and Associated S. S. K. and K. S. C. Hospitals, New Delhi-110001, India.
authors.forename: Neelu
authors.initials: N
authors.lastname: Sharma
authors.forename: Vibhu
authors.initials: V
authors.lastname: Mendiratta
authors.forename: Ravi Chandra
authors.initials: RC
authors.lastname: Sharma
authors.forename: Upma
authors.initials: U
authors.lastname: Hemal
authors.forename: Monica
authors.initials: M
authors.lastname: Verma
mesh_terms: D000192:Actinomycetales / Q000302:isolation & purification; D000193:Actinomycetales Infections / Q000188:drug therapy* / Q000473:pathology*; D000328:Adult; D000583:Amikacin / Q000008:administration & dosage*; D001707:Biopsy, Needle; D003622:Dapsone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008271:Mycetoma / Q000188:drug therapy / Q000473:pathology*; D020551:Pulse Therapy, Drug; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000583:Amikacin; D003622:Dapsone