Successful treatment of Nocardia actinomycetoma with meropenem and amikacin combination therapy.

Author(s): Ameen M, Vargas F, Arenas R, del Mercado EV

Affiliation(s): Department of Dermatology, Royal Free Hampstead NHS Trust, London, UK. mahreenameen@hotmail.com

Publication date & source: 2011-04, Int J Dermatol., 50(4):443-5.

Publication type: Case Reports

BACKGROUND: Actinomycetomas are chronic, granulomatous, subcutaneous infections caused by the traumatic inoculation of actinomycetes bacteria into the skin which produces nodular lesions with draining sinuses and discharging grains. Actinomycetomas can cause profound disability, and despite long-term chemotherapy, treatment failure is common. AIMS: We investigated the efficacy of a novel drug regimen for the treatment of a severe case of Nocardia actinomycetoma of the leg. MATERIAL AND METHODS: A 31-year-old man was treated with an initial three-week parenteral course of meropenem and amikacin combination therapy followed by long term oral sulphonamides. RESULTS: Treatment was well-tolerated with no adverse effects, and there was complete clinical and microbiological cure with no recurrence. CONCLUSION: Meropenem and amikacin combination therapy represents an important addition to the currently available treatments for actinomycetomas. (c) 2011 The International Society of Dermatology.