Actinomycetoma is a subcutaneous infection caused by filamentous bacteria, usually from the Actinomycetaceae family. It is most common in tropical and subtropical regions and is caused by traumatic introduction of the bacteria into the skin. The infection is characterized by progressive, painless, indurated lesions with draining sinuses, and is often misdiagnosed as a tumor. Treatment usually involves a combination of antibiotics and surgical debridement of the affected area.
Pathogenesis
Actinomycetoma is caused by filamentous bacteria, most commonly from the Actinomycetaceae family. It is thought to be contracted through traumatic introduction of the bacteria into the skin. The bacteria then spread through the tissues, forming a mass of tangled filaments that destroy the surrounding tissue. This leads to the formation of a chronic, indurated lesion with draining sinuses and characteristic sulfur granules.
Clinical Presentation
Patients typically present with chronic, painless indurated lesions, which may be accompanied by draining sinuses. The lesions grow slowly and may spread to adjacent tissues. As the lesions spread, they may form a mass of tangled filaments and cause destruction of the surrounding tissue. In some cases, the lesions may be mistaken for a tumor.
Diagnosis
The diagnosis of actinomycetoma is usually based on the clinical presentation and characteristic sulfur granules found in the tissue. A biopsy of the affected area may also be done to confirm the diagnosis. Microscopic examination of the biopsy will reveal the presence of filamentous bacteria and sulfur granules.
Treatment
Treatment of actinomycetoma usually involves a combination of antibiotics and surgical debridement of the affected area. The antibiotics used may include penicillin, tetracycline, and minocycline. In severe cases, amputation of the affected limb may be necessary.