Actinomycetoma (Madura Foot)

Figure 4.13 A: Actinomycosis (Courtesy of Dr. Paul Getz) B: Actinomycosis, chest (Courtesy of Dr. Vandana ehta, India) C: Actinomycetoma, arm (Courtesy of Dr. Paul Getz) D: Green nail syndrome
Figure 4.13
A: Actinomycosis
(Courtesy of Dr. Paul Getz)
B: Actinomycosis, chest
(Courtesy of Dr. Vandana ehta,
India
)
C: Actinomycetoma, arm
(Courtesy of Dr. Paul Getz)
D: Green nail syndrome
(Figure 4.13C)
  • Suppurative infection caused by bacteria (actinomycetoma) or fungus (eumycetoma)
  • Bacterial infection due to Nocardia brasiliensis, Nocardia asteroides, Actinomadura madurae, Actinomadura pelletieri, Streptomyces somaliensis
  • Presents as painless nodules at site of trauma (typically on foot) → increases in size with purulence, tumefaction, draining sinuses, and exudate containing grains
  • Treatment: surgical debridement, trimethroprim-sulfamethoxazole (if sulfa-allergic, can use minocycline)
   
 
Grain ColorOrganism
 
White
Nocardia brasiliensis, Nocardia asteroides
 
Pink or cream
Actinomadura madurae
 
Yellow to brown
Streptomyces somaliensis
 
Red
Actinomadura pelletieri