Actinomycetoma

Actinomycetoma_before_treatment.tif

Actinomycetoma is a chronic subcutaneous infection caused by actinomycetes, a group of bacteria that are filamentous and branching. This condition is a type of mycetoma, which is characterized by the formation of granulomas and abscesses, leading to the destruction of tissue and bone.

Etiology

Actinomycetoma is primarily caused by actinomycetes such as Nocardia, Streptomyces, and Actinomadura. These organisms are commonly found in soil and decaying organic matter. Infection typically occurs when the skin is punctured by a thorn or splinter, allowing the bacteria to enter the subcutaneous tissue.

Clinical Features

The clinical presentation of actinomycetoma includes:

• Swelling of the affected area
• Formation of multiple sinus tracts
• Discharge of serous or purulent material containing sulfur granules
• Progressive destruction of soft tissue and bone

Diagnosis

Diagnosis of actinomycetoma is based on clinical features, histopathology, and microbiological studies. Imaging techniques such as X-ray and MRI can help assess the extent of tissue and bone involvement. Culture and PCR can be used to identify the causative organism.

Treatment

Treatment of actinomycetoma involves prolonged courses of antibiotics such as sulfonamides, aminoglycosides, and tetracyclines. In severe cases, surgical debridement or amputation may be necessary to remove infected tissue.

Prevention

Preventive measures include wearing protective clothing and footwear to avoid skin injuries, especially in endemic areas. Prompt cleaning and care of wounds can also reduce the risk of infection.

Epidemiology

Actinomycetoma is more common in tropical and subtropical regions, particularly in countries with a high prevalence of agriculture and outdoor activities. It affects individuals of all ages but is more common in adult males.

See Also

• Mycetoma
• Nocardia
• Streptomyces
• Actinomadura
• Subcutaneous infection