Actinomicetoma plantar en un paciente sin factores de riesgo / Plantar actinomycetoma in a patient without risk factors

Resumen Se presenta un caso clínico de un actinomicetoma plantar en un paciente sin factores de riesgo, cuyo diagnóstico fue realizado mediante una biopsia de tejido plantar por sospecha de una neoplasia. Dado que el paciente no respondió satisfactoriamente a la terapia de primera línea, debió completar 24 semanas de tratamiento con doxiciclina, a lo cual evolucionó favorablemente. Finalmente, se desarrolla una breve discusión sobre los micetomas plantares.

A case of plantar actinomycetoma without risk factors is presented, which was diagnosed by hystopatological analysis of a foot biopsy because of the suspicion of neoplasia. Since the patient did not fully respond to the first-line therapy antibiotics, a 24-weeks doxycycline regime was started, achieving a satisfactory response. Finally, a brief discussion on plantar mycetomas is presented.

Interdigital foot infections: Corynebacterium minutissimum and agents of superficial mycoses

Interdigital foot infections are mostly caused initially by dermatophytes, yeasts and less frequently by bacteria. Erythrasma caused by Corynebacterium minutissimum can be confused with superficial mycoses. The aim of the study was to determine the prevalence of the etiologic agents of superficial mycoses and the frequency of Corynebacterium minutissimum in interdigital foot infections. All the samples obtained from the 121 patients with interdigital foot infections were examined directly with the use of 20% potassium hydroxide mounts and Gram stain under the microscope and cultured on Sabouraud's dextrose agar plates. In identification of superficial mycoses, the rate was found to be 14% with the cultural method and 14% with direct microscopic examination. Using a combination of direct microscopic examination and culture, a 33.8% ratio was achieved. In the culture of these samples, the most isolated factor was Trichophyton rubrum (33.7%). In 24 of the patients (19.8%) Corynebacterium minutissimum was detected by Gram staining, in 6 of these patients Trichophyton rubrum was found, Trichophyton mentagrophytes was found in 2 and Trichosporon spp. was found in 1. The examination of interdigital foot lesions in the laboratory, the coexistence of erythrasma with dermatophytes and yeast should be considered.

Avaliaçäo fisico-química e microbiológica das soluçöes desinfetantes de sulfato de cobre a 5 por cento e cloridrato de polihexametileno biguanida a 1 por cento em pedilúvio para bovinos / Evaluation physical-chemistries and microbiology of the treatment with desinfections solutions as copper sulphate to 5 percent and chloridrate of polihexametilen biguanide at 1 percent in footbath for bovines

O propósito deste estudo foi avaliar aspectos físico-químicos e microbiológicos do sulfato de cobre a 5 por cento e cloridrato de polihexametileno biguanida (P.H.M.B.) a 1 por cento como soluçöes desinfetantes em pedilúvio para tratamento de diversas afecçöes podais em bovinos associado a procedimentos cirúrgicos e à antibioticoterapia parenteral. As análises físico-químicas constaram da determinaçäo do pH e da concentraçäo do cobre e cloridrato de polihexametileno biguanida (P.H.M.B.). As análises microbiológicas realizadas foram a contagem de microorganismos aeróbios ou facultativos mesófilos e anaeróbios mesófilos. Os resultados obtidos permitem afirmar que as características físico-químicas das duas soluçöes mantiveram-se praticamente constantes e que a soluçäo de PHMB a 1 por cento apresentou menores contagens de microorganismos aeróbios ou facultativos mesófilos e anaeróbios mesófilos do que a soluçäo de sulfato de cobre a 5 por cento.

Clinical and bacteriological study of severe foot infection in diabetic patients

Forty eight diabetic patients underwent emergency procedures for severe foot infection and were subjected for different techniques for isolation and identification of both aerobic and anaerobic bacteria. The isolates were further tested for susceptibility to different antimicrobial agents. None of the patients underwent arterial reconstruction. Twenty patients required major amputation, 11 below the knee, 8 above the knee and one hip disarticualtion. The patients most likely to require a major amputation were those with an absent dorsalis pedis pulse and polymicrobial infection. The amputation rate was higher for patients with non palpable pedal pulses [P<0.05]. There were a total of 105 bacterial isolates [60 aerobes and 45 anaerobes] representing an average of 2.2 isolates per specimen [1.3 aerobes and 0.9 anaerobes]. The most frequent aerobic isolates were Staph. aureus, proteus species [sp.] and enterococci representing 23.3% 15% of the total aerobic isolates respectively. Major anaerobes were Bacteroides sp. and peptococci representing 48.5% and 22.2% of the total anaerobic isolates respectively. The highest results of anaerobes were yielded by enrichment in liquid media and subculture on selective media and by direct plating on non selective media. The most active antimicrobial agents against aerobes were amikacin [81.7%], ofloxacin [80%] and cefotaxime [61.7%] whereas metronidazole [86.7%] and clindamycin [73.3] were the most active antimicrobial agents against an aerobes. Data in the current study suggest that early major amputation in a subset of patients would prevent delay in the rehabilitation process of the amputee, decrease long term morbidity and reduce health care cost. Knowledge about the bacterial agents in this setting and their sensitivity to different antimicrobial agents would help in proper management of these cases

Infección de pie por Mycobacterium chelonei: informe de un caso y revisión de la literatura / Foot infection by Mycobacterium chelonei: a case report and literature review

Presentamos el caso de un niño de occho años que desarrolló una infección del pie despues de un trauma plantar. El estudio bacteriológico demostró la presencia de Mycobacterium chelonei ssp. abscessus en el exudado de la lesión. Se hace una reseña de ña evolución clínica, que finalmente fue satisfactoria después del tatamiento por varias semanas con antimicrobianos y drenajes quirúrgicos. Se hace uma revisión de la literatura para llamar la atención sobre este tipo de infecciones en nuestro medio

Bacterial flora of ulcers treated by three types of dressings.

Effect of three types of dressings on bacterial flora in ulcers is presented. Debrisan seemed to be more effective than Zinc tape and collagen sheet in reducing the number of bacterial pathogens.