DOI: 10.36347/sjmcr.2018.v06i05.001

Pages: 289-293

Mycetoma is a chronic, progressive and destructive disease which affects skin, subcutaneous and connective tissue, muscles and bones. It is usually found on foot, but any part of body could be involved. Infection probably results from traumatic inoculation of subcutaneous tissues with certain funguses or bacterias. The aim of this article is to study the medical management of one case of an ankle mycetoma. These were a 28 year’s old married woman. She is Malian and lived in Bourem Fougas in the Northern part of Mali (sahelian area); she showed a wound on her right ankle. The patient presented a hot pain tumefaction associated with a flow of fluid on her right ankle. In biological examination, we noted an increase of both sedimentation rate (47mm) and C - reactive protein (81mg/l); hemogramm revealed an inflammatory type of anemia and a polyclonal Hypergammaglobulinemia. Biopsy revealed single and white-grain mycetoma (Actinomadura pelletieri). Two drugs were prescribed, cotrimoxazole and diclofenac. The dosage of cotrimaxole was 1920 mg a day for a period of 6 months, and the dosage of diclofenac was 100 mg a day for a period of 15 days. Mycetoma is a chronic subcutaneous infection of tropical region. Etiological agents were actinomycetes or fungus. Its frequency is high in sahelian area, but there is an issue of diagnosis. Functional and vital prognostic could be involved. The treatment is first medical. Then, severe cases require surgical treatment.