Histological and microbiological aspects of actinomycetoma cases in Venezuela

Serrano, José Antonio; Beaman, Blaine; Mejia, Maria Antonieta; Viloria, Jesus Eduardo; Zamora, Ramón

doi:10.1590/S0036-46651988000400009

Abstracts

A ten year (1976-1986) review study of cases of Actinomycetoma in Venezuela was made through personal interview and clinical examinations, analysis of medical records of patients with actinomycetoma, histological studies of biopsy samples, as well as microbiological studies of isolates strain, also through out personal interviews with researchers and dermatologists who were sources of information on mycetoma cases. A total of 47 cases were recorded. As etiologic agent Actinomadura madurae was found in 20 cases - (42.5%), Nocardia brasiliensis in 13 cases (27.6%), Nocardia spp 7 cases (14.8%), Streptomyces somaliensis in 4 cases (8.5%), N. asteroides in 2 cases (4.2%) and N. otitidis caviarum, (N. caviae) in 1 case (2.1%). Most of the reported cases involved individuals living and working in rural areas, mostly males who outnumber females 4:1. The patients were 18 to 80 years old. A. madurae was reported as the most frequent etiologic agent. Most of the clinical cases were seen when the disease was well established. Twenty four of the forty seven cases reported were observed in Lara State, which represents a 51.0% of all the cases studied.

Actinomycetoma; histopathology; incidence in Venezuela; Aerobic actinomycetales

Os autores, em um período de 10 anos (1976/1986) realizaram urn estudo clínico, histopatológico e micológico em 47 casos de actinomicetoma. Os agentes etiológicos isolados foram: Actinomadura madurae - 20 cases (42,5%); Nocardia brasiliensis - 13 casos (27,6%); Nocardia spp - 7 casos (14,8%), Streptomyces somaliensis - 4 casos (8,5%); Nocardia asteroides - 2 casos (4,2%) e N. otitidis caviarum (N. caviae) - 1 caso (2,1%). A maioria dos casos procedia de zona rural, prevalecendo a infecção no sexo masculino (4:1). A idade dos pacientes variou de 18 a 80 anos. Dos 47 casos registrados, 24 foram observados no Estado de Lara. representando 51% do total das observações.

CASE REPORT

José Antonio Serrano^I; Blaine Beaman^II; Maria Antonieta Mejia^III; Jesus Eduardo Viloria^IV; Ramón Zamora^V

^IDepartment of Pathology, School of Medicine University of Los Andes, Mérida 5101, Venezuela

^IIDepartment of Medical Microbiology, School of Medicine, University of California. Davis, CA 95616, USA

^IIIDermatology Service, Central Hospital "Antonio M. Pineda" and School Medicine "Universidad Centro Occidental Lisandro Alvarado" UCLA. Barquisimeto, Venezuela

^IVPathology Service, IVSS "Pastor Oropeza" Hospital, Barquisimeto, Venezuela

^VMicrobiology Department UCLA, Barquisimeto, Venezuela

SUMMARY

A ten year (1976-1986) review study of cases of Actinomycetoma in Venezuela was made through personal interview and clinical examinations, analysis of medical records of patients with actinomycetoma, histological studies of biopsy samples, as well as microbiological studies of isolates strain, also through out personal interviews with researchers and dermatologists who were sources of information on mycetoma cases. A total of 47 cases were recorded.

As etiologic agent Actinomadura madurae was found in 20 cases - (42.5%), Nocardia brasiliensis in 13 cases (27.6%), Nocardia spp 7 cases (14.8%), Streptomyces somaliensis in 4 cases (8.5%), N. asteroides in 2 cases (4.2%) and N. otitidis caviarum, (N. caviae) in 1 case (2.1%). Most of the reported cases involved individuals living and working in rural areas, mostly males who outnumber females 4:1. The patients were 18 to 80 years old. A. madurae was reported as the most frequent etiologic agent. Most of the clinical cases were seen when the disease was well established. Twenty four of the forty seven cases reported were observed in Lara State, which represents a 51.0% of all the cases studied.

Key words: Actinomycetoma - histopathology - incidence in Venezuela; Aerobic actinomycetales.

RESUMO

Os autores, em um período de 10 anos (1976/1986) realizaram urn estudo clínico, histopatológico e micológico em 47 casos de actinomicetoma. Os agentes etiológicos isolados foram: Actinomadura madurae - 20 cases (42,5%); Nocardia brasiliensis - 13 casos (27,6%); Nocardia spp - 7 casos (14,8%), Streptomyces somaliensis - 4 casos (8,5%); Nocardia asteroides - 2 casos (4,2%) e N. otitidis caviarum (N. caviae) - 1 caso (2,1%). A maioria dos casos procedia de zona rural, prevalecendo a infecção no sexo masculino (4:1). A idade dos pacientes variou de 18 a 80 anos. Dos 47 casos registrados, 24 foram observados no Estado de Lara. representando 51% do total das observações.

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ACKNOWLEDGEMENTS

This investigation was supported by Grants from the "Consejo Nacional de Investigaciones Científicas y Tecnológicas" (CONICIT) Caracas, Venezuela, Nº S1-1263. "Consejo de Desarrollo Científico y Tecnológico (CDCHT) from the University of Los Andes, Mérida, Venezuela. Nº M-154-79 and by the "Ministerio de Sanidad y Asistencia Social (SAS) Venezuela".

We thank Yolanda Bartolomé and Enrique Garcia for their technical help, Rosario Quintero for typing the manuscript. Rafael Simón Oropeza for his assistance as a driver in the field work As well as the staff from the "Unidad de Investigaciones en Ultraestructura" CADISUCLA Barquisimeto, Venezuela. This research has been conducted as part of a cooperative effort of the International Group for the study of the pathogenicity of the Actinornycetes (IGSPA).

Recebido para publicação em 23/9/1987.

This work was presented at the 2nd International Symposium on Mycetomas, Taxco, México, (16 to 20 October, 1987).

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