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A 30-year-old farmer from Savannakhet Province in Laos had developed on his right foot a large, brownish-coloured, painless swelling from which oozed a discharge containing bacteria of the Nocardia aobensis species.
It was a case of actinomycosis, often called mycetoma. Mycetoma is described as a chronic infection of the skin, soft tissues or bones caused by either bacteria or fungi, which presumably enter by small skin lesions, mostly of the feet. Wearing shoes or flip-flops would probably prevent most cases. Antibiotic treatment was initiated according to international guidelines, but after two weeks, the patient left the hospital to go to work and thereby terminated treatment, although guidelines recommend continuation for several months. Several months later, the patient reported that without further antibiotics the lesion spontaneously had improved after approximately 20-25 weeks. This case suggests that short-term antibiotic treatment might be sufficient.
Jörg Blessmann and external co-operation partners (see publication)