A Neglected Swollen Limb: Resurgence or Common Tropical Disease?

Mycetoma is uncommon, chronic granulomatous infection caused either by fungi or by aerobic filamentous actinomycetes which is characterized by a triad of painless subcutaneous mass, multiple sinuses and discharge containing grains. We report a case of 40 years old male, farmer who presented with mu...

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Main Authors: Sumit Ray, Deeptara Pathak Thapa
Format: Article
Language:English
Published: Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON) 2023-03-01
Series:Nepal Journal of Dermatology, Venereology & Leprology
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Online Access:https://www.nepjol.info/index.php/NJDVL/article/view/51677
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author Sumit Ray
Deeptara Pathak Thapa
author_facet Sumit Ray
Deeptara Pathak Thapa
author_sort Sumit Ray
collection DOAJ
description Mycetoma is uncommon, chronic granulomatous infection caused either by fungi or by aerobic filamentous actinomycetes which is characterized by a triad of painless subcutaneous mass, multiple sinuses and discharge containing grains. We report a case of 40 years old male, farmer who presented with multiple painless swollen lesions over right foot for 8 years. Swelling had gradually increased in size over a few years followed by multiple episodes of discharge. It had not restricted his daily activities. On examination, there were multiple nodules and sinuses discharging serous fluid from the right foot. Gram staining showed gram positive filamentous rods and KOH was negative. Histopathology showed multiple granulomas. Patient was treated for 5 cycles using modified Welsh regimen with Amikacin 750mg intravenously once a day, oral Cotrimoxazole 960mg twice daily and oral Rifampicin 600mg once daily along with oral iron and folic acid supplementation continuously for 21days which constituted 1 cycle with an interval of 15 days between each cycle. Patient was assessed by measuring girth of foot and number of lesions in each visit and showed significant improvement at the end of fifth cycle. Patient was followed for 1 year after treatment without any recurrence.
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2091-167X
language English
publishDate 2023-03-01
publisher Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)
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series Nepal Journal of Dermatology, Venereology & Leprology
spelling doaj-art-c616bba7523d4374baf3fe3270346fcc2025-08-23T10:03:47ZengSociety of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)Nepal Journal of Dermatology, Venereology & Leprology2091-02312091-167X2023-03-0121110.3126/njdvl.v21i1.51677A Neglected Swollen Limb: Resurgence or Common Tropical Disease?Sumit Ray0https://orcid.org/0000-0002-9103-4075Deeptara Pathak Thapa1https://orcid.org/0000-0002-1602-415XNepal Medical College and Teaching Hospital, Attarkhel, Kathmandu, NepalNepal Medical College and Teaching Hospital, Attarkhel, Kathmandu, Nepal Mycetoma is uncommon, chronic granulomatous infection caused either by fungi or by aerobic filamentous actinomycetes which is characterized by a triad of painless subcutaneous mass, multiple sinuses and discharge containing grains. We report a case of 40 years old male, farmer who presented with multiple painless swollen lesions over right foot for 8 years. Swelling had gradually increased in size over a few years followed by multiple episodes of discharge. It had not restricted his daily activities. On examination, there were multiple nodules and sinuses discharging serous fluid from the right foot. Gram staining showed gram positive filamentous rods and KOH was negative. Histopathology showed multiple granulomas. Patient was treated for 5 cycles using modified Welsh regimen with Amikacin 750mg intravenously once a day, oral Cotrimoxazole 960mg twice daily and oral Rifampicin 600mg once daily along with oral iron and folic acid supplementation continuously for 21days which constituted 1 cycle with an interval of 15 days between each cycle. Patient was assessed by measuring girth of foot and number of lesions in each visit and showed significant improvement at the end of fifth cycle. Patient was followed for 1 year after treatment without any recurrence. https://www.nepjol.info/index.php/NJDVL/article/view/51677BacteriaFungiGranuloma
spellingShingle Sumit Ray
Deeptara Pathak Thapa
A Neglected Swollen Limb: Resurgence or Common Tropical Disease?
Nepal Journal of Dermatology, Venereology & Leprology
Bacteria
Fungi
Granuloma
title A Neglected Swollen Limb: Resurgence or Common Tropical Disease?
title_full A Neglected Swollen Limb: Resurgence or Common Tropical Disease?
title_fullStr A Neglected Swollen Limb: Resurgence or Common Tropical Disease?
title_full_unstemmed A Neglected Swollen Limb: Resurgence or Common Tropical Disease?
title_short A Neglected Swollen Limb: Resurgence or Common Tropical Disease?
title_sort neglected swollen limb resurgence or common tropical disease
topic Bacteria
Fungi
Granuloma
url https://www.nepjol.info/index.php/NJDVL/article/view/51677
work_keys_str_mv AT sumitray aneglectedswollenlimbresurgenceorcommontropicaldisease
AT deeptarapathakthapa aneglectedswollenlimbresurgenceorcommontropicaldisease
AT sumitray neglectedswollenlimbresurgenceorcommontropicaldisease
AT deeptarapathakthapa neglectedswollenlimbresurgenceorcommontropicaldisease