A 40-year-old man from West Africa presents with a chronic draining sinus on his foot with discharge of pale yellow grains. Microscopy of crushed grai...

Question

A 40-year-old man from West Africa presents with a chronic draining sinus on his foot with discharge of pale yellow grains. Microscopy of crushed grains shows thin branching filaments that are Gram-positive and partially acid-fast. Culture grows Actinomadura madurae. What is the recommended treatment?

Accepted Answer

Combined antibiotic therapy - typically co-trimoxazole (first-line) with or without amikacin or streptomycin for 6-12 months or longer

Answer

Surgical excision alone

Answer

Itraconazole for 12 months

Answer

Praziquantel

Answer

Topical antifungal cream

uk-dtmh MCQ (SBA): Actinomycetoma Treatment