Histological and microbiological aspects of actinomycetoma cases in Venezuela.

A ten y e a r (1976-1986) rev iew s t u d y of c a s e s of A c t i n o m y c e t o m a i n V e n e z u e l a w a s m a d e t h r o u g h p e r s o n a l i n te rv iew a n d c l i n i c a l e x a m i n a t i o n s , a n a l y s i s of m e d i c a l r eco rds of p a t i e n t s w i t h a c t i n o m y c e t o m a , h i s t o l o g i c a l s t u d i e s of b i o p s y s a m p l e s , as we l l as m i c r o b i o l o g i c a l s t u d i e s of i so la tes s t r a i n , a lso t h r o u g h ou t p e r s o n a l interv i ews w i t h resea rche rs a n d d e r m a t o l o g i s t s w h o were sou rces of i n f o rma t i on on m y c e t o m a c a s e s . A to ta l of 47 c a s e s were reco rded . A s e t i o l og i c a g e n t A c t i n o m a d u r a m a d u r a e w a s f ound i n 20 c a s e s — (42.5%), N o c a r d i a b r a s i l i e n s i s i n 13 c a s e s (27.6%), N o c a r d i a s p p 7 cases (14.8%), S t r e p t o m y c e s s o m a l i e n s i s i n 4 c a s e s (8.5%), N. a s t e r o i d e s i n 2 c a s e s (4.2%?) a n d N. o t i t i d i s c a v i a r u m , (N. c a v i a e ) i n 1 c a s e ( 2 . 1 % ) . M o s t of t h e r e p o r t e d c a s e s i n v o l v e d i n d i v i d u a l s l i v i n g a n d w o r k i n g i n r u r a l a reas , m o s t l y m a l e s w h o o u t n u m b e r fema les 4:1. T h e p a t i e n t s were 18 to 80 y e a r s o ld . A . m a d u r a e w a s repor ted as the m o s t f requent e t i o l og i c a g e n t . M o s t of the c l i n i c a l c a s e s were seen w h e n the d i s e a s e w a s we l l e s t a b l i s h e d . T w e n t y four of the for ty s e v e n c a s e s repor ted were o b s e r v e d i n L a r a S t a t e , w h i c h rep resen ts a 51.0% of a l l the c a s e s s t u d i e d .