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Tropical infections and infestations
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Once the granuloma forms it increases in size, and the overlying skin becomes stretched, smooth, shiny and attached to the lesion. Areas of hypo- or hyperpigmentation sometimes develop. Eventually it invades the deeper structures. This is usually gradual and delayed in eumycetoma. In actinomycetoma, invasion to deeper tissues occurs earlier and is more extensive. The tendons and nerves are spared until late in the disease. This may explain the rarity of neurological and trophic changes even in patients with long-standing disease. Trophic changes are rare because the blood supply is adequate.
Tedizolid
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Few studies have evaluated synergistic or antagonistic potential with tedizolid and other antibiotics. Antagonism between tedizolid and other antimicrobials has not been observed (Merck, 2014), and synergy is unlikely. In a rat model simulating chronic foreign body MRSA osteomyelitis, tedizolid plus rifampin did not produce additional decrease in bacterial counts compared with tedizolid alone. (Greenwood-Quaintance et al., 2016). Similar findings were observed when tedizolid was studied alone and in combination with trimethoprim–sulfamethoxazole against N. brasiliensis in an experimental actinomycetoma murine model. Although both treatment groups effectively decreased lesions, combination therapy did not confer any additional benefits compared with tedizolid monotherapy (Espinoza-González et al., 2010). Tedizolid did appear to provide some synergistic activity in one study when added to bedaquiline plus pretomanid in an M. tuberculosis mouse infection model. The three-drug regimen demonstrated significantly improved bactericidal activity 2 months after initiation compared with bedaquiline plus pretomanid alone, although these findings were not observed at 1 month (Tasneen et al., 2016).
Actinomycetoma by Actinomadura madurae. Clinical and therapeutic characteristics of 18 cases with two treatment modalities
Published in Journal of Dermatological Treatment, 2022
Alexandro Bonifaz, Andrés Tirado-Sánchez, Denisse Vázquez-González, Leonel Fierro-Arias, Javier Araiza, Gloria M. González
This was a retrospective study of actinomycetoma cases treated in the last ten years (from January 2010 to December 2019) in a tertiary-level hospital. Patients with actinomycetoma due to Actinomadura madurae, confirmed by microbiological studies and histopathology were included. In each case, a direct examination was carried out with KOH to identify the grains, as well as the isolation in three culture media (Saboraud-dextrose agar, Lowenstein-Jensen agar, and coconut water agar), and later morphologically classified with Gram staining. The cultures were identified by biochemical tests, using the automated ATB Vitek® 1574 system (Biomèrieux), after incubation for seven days at 28 °C. Histopathological evaluation was performed with Hematoxylin & Eosin stains and periodic Schiff acid staining. Patients were treated with a conventional regimen with streptomycin (IM) 1 g on the third day (3 g weekly) up to a maximum of 50 g plus TMP/SMX 800 mg/160 mg every 12 h, continuing with TMP/SMX plus DDS 100 mg/day. In a smaller proportion of patients, streptomycin 1 g IM was used every third day (3 g weekly) up to a maximum of 50 g plus TMP/SMX 800 mg/160 mg every 12 h, continuing with TMP/SMX plus ciprofloxacin 500 mg every 12 h. In both schemes, the total duration of treatment was based on the clinical and microbiological response.