Actinomycetoma of the arm disseminated to the chest wall
Benhiba Hind, Hassam Badredine
The Pan African Medical Journal. 2015;20:306. doi:10.11604/pamj.2015.20.306.5766

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Actinomycetoma of the arm disseminated to the chest wall

Cite this: The Pan African Medical Journal. 2015;20:306. doi:10.11604/pamj.2015.20.306.5766

Received: 13/11/2014 - Accepted: 01/12/2014 - Published: 30/03/2015

Key words: Actinomycetoma,arm,chest

© Benhiba Hind et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/20/306/full

Corresponding author: Benhiba Hind , Department of Dermatology, Ibn Sina Hospital, Faculty of Medecine and Pharmacy, University Mohamed V- Souissi, Rabat, Morocco (dr.benhiba.hind@gmail.com)


Actinomycetoma of the arm disseminated to the chest wall

 

Benhiba Hind 1,&, Hassam Badredine 1

 

1Department of Dermatology, Ibn Sina Hospital, Faculty of Medecine and Pharmacy, University Mohamed V- Souissi, Rabat, Morocco

 

 

&Corresponding author
Benhiba Hind , Department of Dermatology, Ibn Sina Hospital, Faculty of Medecine and Pharmacy, University Mohamed V- Souissi, Rabat, Morocco

 

 

Image in medicine

A 27-year-old immigrant sought care for inflammatory nodular swelling lesions over the right arm extending upto the neck with axillary and cervical fistulas lasting for six months (A). His medical history was marked by a long forest stay due to conflicts in his homeland (Mali). A deep biopsy was made for infectious and histopathological examinations. Cultures were negative. Microscopy on hematoxylin and eosin stained sections showed nodular abscesses organized around multilobated grains showing Splendore-Hoeppli Phenomenon (B). Special stains (Gram, Ziehl-Neelsen, Gomori Grocott) were positive. Thus, the histological diagnosis of actinomycetoma probably due to Nocardia was given. In addition, laboratory tests revealed an active hepatitis B infection. After consulting hepatologists, treatment with trimethoprim-sulfametoxazol was introduced, substituted by amoxicillin clavulanate for months with partial clinical response. The evolution was characterized by the reduction of right arm lesions but extension of the infection to the chest wall.

 

 

Figure 1: (A) inflammatory nodules of the right arm; (B) cutaneous histology (HE x400): Splendore Hoeppli phenomenon

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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