title: Successful treatment of Nocardia actinomycetoma with meropenem and amikacin combination therapy.
abstract: BACKGROUND
  Actinomycetomas are chronic, granulomatous, subcutaneous infections caused by the traumatic inoculation of actinomycetes bacteria into the skin which produces nodular lesions with draining sinuses and discharging grains. Actinomycetomas can cause profound disability, and despite long-term chemotherapy, treatment failure is common.
  
  
  OBJECTIVE
  We investigated the efficacy of a novel drug regimen for the treatment of a severe case of Nocardia actinomycetoma of the leg.
  
  
  METHODS
  A 31-year-old man was treated with an initial three-week parenteral course of meropenem and amikacin combination therapy followed by long term oral sulphonamides.
  
  
  RESULTS
  Treatment was well-tolerated with no adverse effects, and there was complete clinical and microbiological cure with no recurrence.
  
  
  CONCLUSIONS
  Meropenem and amikacin combination therapy represents an important addition to the currently available treatments for actinomycetomas.
authors.affiliation: Department of Dermatology, Royal Free Hampstead NHS Trust, London, UK. mahreenameen@hotmail.com
authors.forename: Mahreen
authors.initials: M
authors.lastname: Ameen
authors.forename: Felipe
authors.initials: F
authors.lastname: Vargas
authors.forename: Roberto
authors.initials: R
authors.lastname: Arenas
authors.forename: Elsa Vásquez
authors.initials: EV
authors.lastname: del Mercado
mesh_terms: D000328:Adult; D000583:Amikacin / Q000008:administration & dosage* / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D000077731:Meropenem; D009617:Nocardia Infections / Q000188:drug therapy / Q000473:pathology; D012720:Severity of Illness Index; D013845:Thienamycins / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000583:Amikacin; D000077731:Meropenem