Clinical characteristics and treatment of actinomycetoma in northeast Mexico: A case series
Mycetoma is a neglected tropical disease characterized by nodules, scars, abscesses, and fistulae that drain serous or purulent material containing the etiological agent. Mycetoma may be caused by true fungi (eumycetoma) or filamentous aerobic bacteria (actinomycetoma). Mycetoma is more frequent in...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2020-02, Vol.14 (2), p.e0008123-e0008123 |
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| creator | Cárdenas-de la Garza, Jesús Alberto Welsh, Oliverio Cuéllar-Barboza, Adrián Suarez-Sánchez, Karina Paola De la Cruz-Valadez, Estephania Cruz-Gómez, Luis Gerardo Gallardo-Rocha, Anabel Ocampo-Candiani, Jorge Vera-Cabrera, Lucio |
| description | Mycetoma is a neglected tropical disease characterized by nodules, scars, abscesses, and fistulae that drain serous or purulent material containing the etiological agent. Mycetoma may be caused by true fungi (eumycetoma) or filamentous aerobic bacteria (actinomycetoma). Mycetoma is more frequent in the so-called mycetoma belt (latitude 15° south and 30° north around the Tropic of Cancer), especially in Sudan, Nigeria, Somalia, India, Mexico, and Venezuela. The introduction of new antibiotics with fewer side effects, broader susceptibility profiles, and different administration routes has made information on actinomycetoma treatment and outcomes necessary. The objective of this report was to provide an update on clinical, therapeutic, and outcome data for patients with actinomycetoma attending a reference center in northeast Mexico.
This was a retrospective, cross-sectional, descriptive study of 31 patients (male to female ratio 3.4:1) diagnosed with actinomycetoma by direct grain examination, histopathology, culture, or serology from January 2009 to September 2018. Most lesions were caused by Nocardia brasiliensis (83.9%) followed by Actinomadura madurae (12.9%) and Actinomadura pelletieri (3.2%). About 50% of patients had bone involvement, and the right leg was the most commonly affected region in 38.7% of cases. Farmers/agriculture workers were most commonly affected, representing 41.9% of patients. The most commonly used treatment regimen was the Welsh regimen (35.5% of cases), a combination of trimethoprim/sulfamethoxazole (TMP/SMX) plus amikacin, which had a 90% cure rate, followed by TMP/SMX plus amoxicillin/clavulanic acid in 19.4% of cases with a cure rate of 100%. In our setting, 28 (90.3%) patients were completely cured and three (9.7%) were lost to follow-up. Four patients required multiple antibiotic regimens due to recurrences and adverse effects.
In our sample, actinomycetoma was predominantly caused by N. brasiliensis. Most cases responded well to therapy with a combination of TMP/SMX with amikacin or TMP/SMX and amoxicillin/clavulanic acid. Four patients required multiple antibiotics and intrahospital care. |
| doi_str_mv | 10.1371/journal.pntd.0008123 |
| format | Article |
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This was a retrospective, cross-sectional, descriptive study of 31 patients (male to female ratio 3.4:1) diagnosed with actinomycetoma by direct grain examination, histopathology, culture, or serology from January 2009 to September 2018. Most lesions were caused by Nocardia brasiliensis (83.9%) followed by Actinomadura madurae (12.9%) and Actinomadura pelletieri (3.2%). About 50% of patients had bone involvement, and the right leg was the most commonly affected region in 38.7% of cases. Farmers/agriculture workers were most commonly affected, representing 41.9% of patients. The most commonly used treatment regimen was the Welsh regimen (35.5% of cases), a combination of trimethoprim/sulfamethoxazole (TMP/SMX) plus amikacin, which had a 90% cure rate, followed by TMP/SMX plus amoxicillin/clavulanic acid in 19.4% of cases with a cure rate of 100%. In our setting, 28 (90.3%) patients were completely cured and three (9.7%) were lost to follow-up. Four patients required multiple antibiotic regimens due to recurrences and adverse effects.
In our sample, actinomycetoma was predominantly caused by N. brasiliensis. Most cases responded well to therapy with a combination of TMP/SMX with amikacin or TMP/SMX and amoxicillin/clavulanic acid. Four patients required multiple antibiotics and intrahospital care.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0008123</identifier><identifier>PMID: 32097417</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abscess ; Abscesses ; Acids ; Adolescent ; Adult ; Aerobic bacteria ; Aged ; Amikacin ; Amoxicillin ; Anti-Bacterial Agents - therapeutic use ; Antibacterial agents ; Antibiotics ; Bacteria ; Biology and Life Sciences ; Cancer ; Clavulanic acid ; Dermatology ; Diseases ; Etiology ; Female ; Fistulae ; Fungi ; Histochemistry ; Histopathology ; Humans ; Lesions ; Longitudinal Studies ; Maduromycosis ; Male ; Medical research ; Medicine and Health Sciences ; Methenamine ; Mexico - epidemiology ; Middle Aged ; Mycetoma - diagnosis ; Mycetoma - drug therapy ; Mycetoma - epidemiology ; Mycetoma - pathology ; Nodules ; Patients ; People and places ; Profiles ; Research and Analysis Methods ; Retrospective Studies ; Scars ; Serology ; Setting (Literature) ; Side effects ; Skin ; Sociodemographics ; Sulfamethoxazole ; Therapy ; Trimethoprim ; Tropical climate ; Tropical diseases ; Workers ; Young Adult</subject><ispartof>PLoS neglected tropical diseases, 2020-02, Vol.14 (2), p.e0008123-e0008123</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Cárdenas-de la Garza et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Cárdenas-de la Garza et al 2020 Cárdenas-de la Garza et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-f632dd277f3f5edb48156d5bf629335977d5b16431dcff9ee5d2629e315da8593</citedby><cites>FETCH-LOGICAL-c624t-f632dd277f3f5edb48156d5bf629335977d5b16431dcff9ee5d2629e315da8593</cites><orcidid>0000-0002-5099-0079 ; 0000-0003-2405-5201 ; 0000-0002-0890-9660</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059949/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059949/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32097417$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ricaldi, Jessica N.</contributor><creatorcontrib>Cárdenas-de la Garza, Jesús Alberto</creatorcontrib><creatorcontrib>Welsh, Oliverio</creatorcontrib><creatorcontrib>Cuéllar-Barboza, Adrián</creatorcontrib><creatorcontrib>Suarez-Sánchez, Karina Paola</creatorcontrib><creatorcontrib>De la Cruz-Valadez, Estephania</creatorcontrib><creatorcontrib>Cruz-Gómez, Luis Gerardo</creatorcontrib><creatorcontrib>Gallardo-Rocha, Anabel</creatorcontrib><creatorcontrib>Ocampo-Candiani, Jorge</creatorcontrib><creatorcontrib>Vera-Cabrera, Lucio</creatorcontrib><title>Clinical characteristics and treatment of actinomycetoma in northeast Mexico: A case series</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Mycetoma is a neglected tropical disease characterized by nodules, scars, abscesses, and fistulae that drain serous or purulent material containing the etiological agent. Mycetoma may be caused by true fungi (eumycetoma) or filamentous aerobic bacteria (actinomycetoma). Mycetoma is more frequent in the so-called mycetoma belt (latitude 15° south and 30° north around the Tropic of Cancer), especially in Sudan, Nigeria, Somalia, India, Mexico, and Venezuela. The introduction of new antibiotics with fewer side effects, broader susceptibility profiles, and different administration routes has made information on actinomycetoma treatment and outcomes necessary. The objective of this report was to provide an update on clinical, therapeutic, and outcome data for patients with actinomycetoma attending a reference center in northeast Mexico.
This was a retrospective, cross-sectional, descriptive study of 31 patients (male to female ratio 3.4:1) diagnosed with actinomycetoma by direct grain examination, histopathology, culture, or serology from January 2009 to September 2018. Most lesions were caused by Nocardia brasiliensis (83.9%) followed by Actinomadura madurae (12.9%) and Actinomadura pelletieri (3.2%). About 50% of patients had bone involvement, and the right leg was the most commonly affected region in 38.7% of cases. Farmers/agriculture workers were most commonly affected, representing 41.9% of patients. The most commonly used treatment regimen was the Welsh regimen (35.5% of cases), a combination of trimethoprim/sulfamethoxazole (TMP/SMX) plus amikacin, which had a 90% cure rate, followed by TMP/SMX plus amoxicillin/clavulanic acid in 19.4% of cases with a cure rate of 100%. In our setting, 28 (90.3%) patients were completely cured and three (9.7%) were lost to follow-up. Four patients required multiple antibiotic regimens due to recurrences and adverse effects.
In our sample, actinomycetoma was predominantly caused by N. brasiliensis. Most cases responded well to therapy with a combination of TMP/SMX with amikacin or TMP/SMX and amoxicillin/clavulanic acid. Four patients required multiple antibiotics and intrahospital care.</description><subject>Abscess</subject><subject>Abscesses</subject><subject>Acids</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aerobic bacteria</subject><subject>Aged</subject><subject>Amikacin</subject><subject>Amoxicillin</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibacterial agents</subject><subject>Antibiotics</subject><subject>Bacteria</subject><subject>Biology and Life Sciences</subject><subject>Cancer</subject><subject>Clavulanic acid</subject><subject>Dermatology</subject><subject>Diseases</subject><subject>Etiology</subject><subject>Female</subject><subject>Fistulae</subject><subject>Fungi</subject><subject>Histochemistry</subject><subject>Histopathology</subject><subject>Humans</subject><subject>Lesions</subject><subject>Longitudinal Studies</subject><subject>Maduromycosis</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Methenamine</subject><subject>Mexico - epidemiology</subject><subject>Middle Aged</subject><subject>Mycetoma - diagnosis</subject><subject>Mycetoma - drug therapy</subject><subject>Mycetoma - epidemiology</subject><subject>Mycetoma - pathology</subject><subject>Nodules</subject><subject>Patients</subject><subject>People and places</subject><subject>Profiles</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>Scars</subject><subject>Serology</subject><subject>Setting (Literature)</subject><subject>Side effects</subject><subject>Skin</subject><subject>Sociodemographics</subject><subject>Sulfamethoxazole</subject><subject>Therapy</subject><subject>Trimethoprim</subject><subject>Tropical climate</subject><subject>Tropical diseases</subject><subject>Workers</subject><subject>Young Adult</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1vEzEQXSEQLYV_gGAlpIpLgj_W690ekKKIj0pFXODEwXLsceLIawfbQfTf10u2VYIqH2zPvHkz82aq6jVGc0w5_rAN--ilm-981nOEUIcJfVKd456yGeGUPT16n1UvUtoixHrW4efVGSWo5w3m59WvpbPeKulqtZFRqgzRpmxVqqXXdY4g8wA-18HUxWl9GG4V5DDI2vrah5g3IFOuv8Ffq8JVvaiVTFCnwgLpZfXMSJfg1XRfVD8_f_qx_Dq7-f7lerm4mamWNHlmWkq0JpwbahjoVdNh1mq2Mi3pKWU95-WD24ZirYzpAZgmxQUUMy071tOL6u2Bd-dCEpMuSRDKOUe4JyPi-oDQQW7FLtpBxlsRpBX_DCGuhYylaweibSRDZGUIZ7jBuOtMqyQHpCkySGsoXB-nbPvVAFoVdaJ0J6SnHm83Yh3-CF7k75uxmPcTQQy_95CyGGxS4Jz0EPZj3S3DfSmbF-i7_6CPdzeh1rI0YL0JJa8aScWixS0jpaGRa_4IqhwNQ5mdB2OL_STg8iigzNnlTQpun23w6RTYHIAqhpQimAcxMBLjrt5XLcZdFdOulrA3x0I-BN0vJ70D4Onlqg</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Cárdenas-de la Garza, Jesús Alberto</creator><creator>Welsh, Oliverio</creator><creator>Cuéllar-Barboza, Adrián</creator><creator>Suarez-Sánchez, Karina Paola</creator><creator>De la Cruz-Valadez, Estephania</creator><creator>Cruz-Gómez, Luis Gerardo</creator><creator>Gallardo-Rocha, Anabel</creator><creator>Ocampo-Candiani, Jorge</creator><creator>Vera-Cabrera, Lucio</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-5099-0079</orcidid><orcidid>https://orcid.org/0000-0003-2405-5201</orcidid><orcidid>https://orcid.org/0000-0002-0890-9660</orcidid></search><sort><creationdate>20200201</creationdate><title>Clinical characteristics and treatment of actinomycetoma in northeast Mexico: A case series</title><author>Cárdenas-de la Garza, Jesús Alberto ; Welsh, Oliverio ; Cuéllar-Barboza, Adrián ; Suarez-Sánchez, Karina Paola ; De la Cruz-Valadez, Estephania ; Cruz-Gómez, Luis Gerardo ; Gallardo-Rocha, Anabel ; Ocampo-Candiani, Jorge ; Vera-Cabrera, Lucio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c624t-f632dd277f3f5edb48156d5bf629335977d5b16431dcff9ee5d2629e315da8593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abscess</topic><topic>Abscesses</topic><topic>Acids</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aerobic bacteria</topic><topic>Aged</topic><topic>Amikacin</topic><topic>Amoxicillin</topic><topic>Anti-Bacterial Agents - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cárdenas-de la Garza, Jesús Alberto</au><au>Welsh, Oliverio</au><au>Cuéllar-Barboza, Adrián</au><au>Suarez-Sánchez, Karina Paola</au><au>De la Cruz-Valadez, Estephania</au><au>Cruz-Gómez, Luis Gerardo</au><au>Gallardo-Rocha, Anabel</au><au>Ocampo-Candiani, Jorge</au><au>Vera-Cabrera, Lucio</au><au>Ricaldi, Jessica N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical characteristics and treatment of actinomycetoma in northeast Mexico: A case series</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>14</volume><issue>2</issue><spage>e0008123</spage><epage>e0008123</epage><pages>e0008123-e0008123</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Mycetoma is a neglected tropical disease characterized by nodules, scars, abscesses, and fistulae that drain serous or purulent material containing the etiological agent. Mycetoma may be caused by true fungi (eumycetoma) or filamentous aerobic bacteria (actinomycetoma). Mycetoma is more frequent in the so-called mycetoma belt (latitude 15° south and 30° north around the Tropic of Cancer), especially in Sudan, Nigeria, Somalia, India, Mexico, and Venezuela. The introduction of new antibiotics with fewer side effects, broader susceptibility profiles, and different administration routes has made information on actinomycetoma treatment and outcomes necessary. The objective of this report was to provide an update on clinical, therapeutic, and outcome data for patients with actinomycetoma attending a reference center in northeast Mexico.
This was a retrospective, cross-sectional, descriptive study of 31 patients (male to female ratio 3.4:1) diagnosed with actinomycetoma by direct grain examination, histopathology, culture, or serology from January 2009 to September 2018. Most lesions were caused by Nocardia brasiliensis (83.9%) followed by Actinomadura madurae (12.9%) and Actinomadura pelletieri (3.2%). About 50% of patients had bone involvement, and the right leg was the most commonly affected region in 38.7% of cases. Farmers/agriculture workers were most commonly affected, representing 41.9% of patients. The most commonly used treatment regimen was the Welsh regimen (35.5% of cases), a combination of trimethoprim/sulfamethoxazole (TMP/SMX) plus amikacin, which had a 90% cure rate, followed by TMP/SMX plus amoxicillin/clavulanic acid in 19.4% of cases with a cure rate of 100%. In our setting, 28 (90.3%) patients were completely cured and three (9.7%) were lost to follow-up. Four patients required multiple antibiotic regimens due to recurrences and adverse effects.
In our sample, actinomycetoma was predominantly caused by N. brasiliensis. Most cases responded well to therapy with a combination of TMP/SMX with amikacin or TMP/SMX and amoxicillin/clavulanic acid. Four patients required multiple antibiotics and intrahospital care.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32097417</pmid><doi>10.1371/journal.pntd.0008123</doi><orcidid>https://orcid.org/0000-0002-5099-0079</orcidid><orcidid>https://orcid.org/0000-0003-2405-5201</orcidid><orcidid>https://orcid.org/0000-0002-0890-9660</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1935-2735 |
| ispartof | PLoS neglected tropical diseases, 2020-02, Vol.14 (2), p.e0008123-e0008123 |
| issn | 1935-2735 1935-2727 1935-2735 |
| language | eng |
| recordid | cdi_plos_journals_2377701929 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Abscess Abscesses Acids Adolescent Adult Aerobic bacteria Aged Amikacin Amoxicillin Anti-Bacterial Agents - therapeutic use Antibacterial agents Antibiotics Bacteria Biology and Life Sciences Cancer Clavulanic acid Dermatology Diseases Etiology Female Fistulae Fungi Histochemistry Histopathology Humans Lesions Longitudinal Studies Maduromycosis Male Medical research Medicine and Health Sciences Methenamine Mexico - epidemiology Middle Aged Mycetoma - diagnosis Mycetoma - drug therapy Mycetoma - epidemiology Mycetoma - pathology Nodules Patients People and places Profiles Research and Analysis Methods Retrospective Studies Scars Serology Setting (Literature) Side effects Skin Sociodemographics Sulfamethoxazole Therapy Trimethoprim Tropical climate Tropical diseases Workers Young Adult |
| title | Clinical characteristics and treatment of actinomycetoma in northeast Mexico: A case series |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T17%3A53%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20characteristics%20and%20treatment%20of%20actinomycetoma%20in%20northeast%20Mexico:%20A%20case%20series&rft.jtitle=PLoS%20neglected%20tropical%20diseases&rft.au=C%C3%A1rdenas-de%20la%20Garza,%20Jes%C3%BAs%20Alberto&rft.date=2020-02-01&rft.volume=14&rft.issue=2&rft.spage=e0008123&rft.epage=e0008123&rft.pages=e0008123-e0008123&rft.issn=1935-2735&rft.eissn=1935-2735&rft_id=info:doi/10.1371/journal.pntd.0008123&rft_dat=%3Cgale_plos_%3EA616525027%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2377701929&rft_id=info:pmid/32097417&rft_galeid=A616525027&rft_doaj_id=oai_doaj_org_article_64a502bf275141188f6ca7e0d30f0dde&rfr_iscdi=true |