RESUMO
Leptosphaeria tompkinsii is a dematiaceous fungus which is rarely reported as an agent of black-grain mycetoma. We present a case involving a mycetoma of the hand of a former farmer from Mali, West Africa, who has been a resident in France for 27 years. The patient was successfully treated with surgery and the use of oral itraconazole for 6 months. Species identification was based on sexual reproductive structures observed on potato-carrot agar media and the use of internal transcribed spacer sequencing.
Assuntos
Ascomicetos/isolamento & purificação , Micetoma/diagnóstico , Adulto , Agricultura , Antifúngicos/administração & dosagem , Ascomicetos/classificação , Desbridamento , Mãos/microbiologia , Mãos/patologia , Humanos , Itraconazol/administração & dosagem , Masculino , Mali , Microscopia , Micetoma/tratamento farmacológico , Micetoma/microbiologia , Micetoma/cirurgia , Micologia/métodosRESUMO
Ano-rectal myectomy, described by B. Duhamel in 1965, is the logical therapy of rectoanal achalasia; an experience of 117 cases is reported. Clinical examination and radiological investigations have been made prior to surgery. This surgical procedure is simple, without complication. Three kinds of rectoanal achalasia are described: achalasia with structural change of the internal sphincter (fibrosis, sclerosis); achalasia with a functional sphincteric disorder (with normal histology); achalasia with intrinsic innervation abnormality. Excellent results have been observed in the two first groups but more variable successful results in the third group which concerns short segments of Hirschsprung's disease.
