[An interesting case of actinomycotic affection of the lower limb.].
The authors deal with a rare case of a 14-year actinomycotic affection of the left lower limb in at present 39 years old female patient. They point out the difficulty and mistakes in the diagnosis of the mentioned disease. During the 14 years the patient was hospitalized, examined and treated at approximately 6-7 clinics all over the republic with different conclusions within the differential diagnosis. It is a fact that the history of the patient was underestimated, not all possibilities of the examination within differential diagnosis were used and at one clinic the histological finding got even lost, the examination was not repeated and the treatment focussed only on the incipient symptoms of the disease. Therefore in the first stage of the disease the diagnostic conclusion was synovialitis of the left ankle, in the following years the tuberculous etiology was suspected and finally the disease was diagnosed as a juvenile rheumatoid progressive ostearthritis with negative rheumatotests. Proper diagnosis was determined only after 13 years (bacteriological tests revealed actinomycotic particles on the dorsum of the left foot, chronic liver lesion and incomplete nephrotic syndrome were diagnosed. However, it has to be taken into account that in the 14-year course of the disease there were several-year periods without subjective complaints and with a complete normalization of the clinical condition. As stated in the discussion it is a rare case of the disease, we have not found in the available literature any similar case study of actinomycotic affection. Key words: actinomycosis of the musculoskeletal apparatus.
Netval
M
M
I. ortopedická klinika 1. LF UK, FN Motol, Praha.
Branald
R
R
Hudec
T
T