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Ginecología y obstetricia de México

versión impresa ISSN 0300-9041

Resumen

ESPINOSA, S et al. Actinomycetoma in pregnancy. Case report: what to do, how to handle?. Ginecol. obstet. Méx. [online]. 2017, vol.85, n.3, pp.190-195. ISSN 0300-9041.

BACKGROUND:

Mycetoma is an infection caused by fungi and aerobic actinomycetes. It is a frequent condition in Mexico; it presents less in women than men (1:3). It is characterized by increased volume deformity of the region and sinuses.

OBJECTIVE:

We present a case of actinomycetoma in a pregnant patient and to analyze the behavior in its therapeutic management

CLINICAL CASE:

We present female, 29 years old, attending her fourth pregnancy at 29 weeks of gestation. It began 13 years ago with a localized dermatosis of the lower left limb, constituted by a painless nodule, remained unchanged until the beginning of the current gestation, developed multiple nodules and sinuses. A direct examination of the secretion was performed, observing grains, Nocardia brasiliensis was identified. After product birth, lactation was allowed for 4 months and discontinued with bromocriptine. The dermatosis extended to double without bone affection, treatment with sulfamethoxazole/trimethoprim + dapsone was given. Total time was 15 months and follow-up without medication for one year. Clinical and microbiological cure was achieved.

CONCLUSIONS:

The development of mycetoma in pregnant women is rare, it is important to know the etiology, in eumycetoma all the antimycotics are teratogenic and in actinomycetoma most antibiotics cannot be used in pregnancy with some exceptions. If mycetoma is located in an area that does not compromise other organs or does not spread it is best to leave the course of pregnancy and lactation and then start treatment.

Palabras llave : Mycetoma; Actinomycetoma; Nocardia brasiliensis; Pregnancy; Sulfamethoxazole/trimetoprim; Dapsone; Lactation.

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