<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412017000300190</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Actinomicetoma en el embarazo. Reporte de un caso: ¿Qué hacer y cómo tratarlo?]]></article-title>
<article-title xml:lang="en"><![CDATA[Actinomycetoma in pregnancy. Case report: what to do, how to handle?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Espinosa]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Perales]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ponce]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Buitrón-García]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bonifaz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General de México Dr. Eduaro Liceaga Dermatóloga ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General de México Dr. Eduaro Liceaga Infectóloga ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital General de México Dr. Eduaro Liceaga Ginecobstetra ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital General de México Dr. Eduaro Liceaga Departamento de Micología ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<volume>85</volume>
<numero>3</numero>
<fpage>190</fpage>
<lpage>195</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412017000300190&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412017000300190&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412017000300190&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES: El micetoma es una infección causada por hongos y actinomicetos aeróbicos. Es un padecimiento frecuente en México, con mayor afectación en hombres que en mujeres (3:1). Se caracteriza por aumento de volumen, deformidad del sistio de lesión y formación de fístulas.  OBJETIVO: Reportar un caso de actinomicetoma durante el embarazo y analizar el protocolo de tratamiento.  CASO CLINICO: Paciente de 29 años de edad, en su cuarto embarazo, con 29 semanas de gestación. El padecimiento se inició 13 años atrás, con dermatosis localizada en la extremidad inferior izquierda, constituida por un nódulo indoloro, que permaneció sin cambios hasta el inicio de la gestación actual, cuando le aparecieron múltiples lesiones nodulares y fístulas. En el examen directo de la secreción se observaron granos y en el cultivo se identificó Nocardia brasiliensis. Después del embarazo a término y con recién nacido sano, si indicó lactancia durante 4 meses y se interrumpió para prescribir bromocriptina. La dermatosis se extendió al doble, sin afectación ósea; se indicó tratamiento con sulfametoxazol-trimetoprima y dapsona. El tiempo total de tratamiento fue de 15 meses y seguimiento sin medicación durante un año. Se obtuvo curación clínica y microbiológica.  CONCLUSIONES: El micetoma en mujeres embarazadas es excepcional. La mayor parte de los portocolos de tratamiento deben contraindicarse durante el embarazo. Cuando el micetoma se localiza en una zona que no afecta otros órganos ni se extiende, se sugiere continuar el embarazo y la lactancia sin prescripción de medicamentos pero iniciarla posterior al nacimiento.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[micetoma]]></kwd>
<kwd lng="es"><![CDATA[actinomicetoma]]></kwd>
<kwd lng="es"><![CDATA[Nocardia brasiliensis]]></kwd>
<kwd lng="es"><![CDATA[embarazo]]></kwd>
<kwd lng="es"><![CDATA[sulfametoxazol-trimetroprim]]></kwd>
<kwd lng="es"><![CDATA[dapsona]]></kwd>
<kwd lng="es"><![CDATA[lactancia]]></kwd>
<kwd lng="en"><![CDATA[Mycetoma]]></kwd>
<kwd lng="en"><![CDATA[Actinomycetoma]]></kwd>
<kwd lng="en"><![CDATA[Nocardia brasiliensis]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy]]></kwd>
<kwd lng="en"><![CDATA[Sulfamethoxazole/trimetoprim]]></kwd>
<kwd lng="en"><![CDATA[Dapsone]]></kwd>
<kwd lng="en"><![CDATA[Lactation]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Mycetoma: experience of 482 cases in a single center of Mexico]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bonifaz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tirado-Sánchez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Calderón]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Saúl]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Araiza]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[PLOS Negl Trop Dis]]></source>
<year>2014</year>
<volume>8</volume>
<numero>8</numero>
<issue>8</issue>
</nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Global burden of human mycetoma: a systematic review and meta-analysis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[van de Sande]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<source><![CDATA[PLOS Negl Trop Dis]]></source>
<year>2013</year>
<volume>7</volume>
<numero>11</numero>
<issue>11</issue>
</nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Actualización de la epidemiología del micetoma en México. Revisión de 3,933 casos]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[López-Martínez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Méndez-Tovar]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bonifaz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Gac Med Mex]]></source>
<year>2013</year>
<volume>149</volume>
<page-range>586-92</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Minimicetoma. Presentación de un caso]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Padilla]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Novales]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Juárez]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Flores]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Cent Dermatol Pascua]]></source>
<year>2004</year>
<volume>13</volume>
<page-range>41-4</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Mycetoma: a thorn in the flesh]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fahal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Trans R Soc Trop Med Hyg]]></source>
<year>2004</year>
<volume>98</volume>
<page-range>3-11</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Mycetoma]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Welsh]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Vera-Cabrera]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Salinas-Carmona]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Clin Dermatol]]></source>
<year>2007</year>
<volume>25</volume>
<page-range>195-202</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Madura foot caused by Actinomadura madurae in a pregnant woman]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yeh]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Dhanireddy]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Arch Dermatol]]></source>
<year>2010</year>
<volume>146</volume>
<page-range>1189-90</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Nocardia braisliensis: in vitro and in vivo growth response to steroid sex hormones]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernández-Hernández]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[López Martínez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Méndez Tovar]]></surname>
</name>
</person-group>
<source><![CDATA[Mycopatologia]]></source>
<year>1995</year>
<volume>132</volume>
<page-range>79-85</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Effets des hormones sexuelles humanines sur le development in vitro des agents D'eumycétomes]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Méndez-Tovar]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Bievre]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[López-Martínez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[J Mycol Med]]></source>
<year>1991</year>
<volume>118</volume>
<page-range>141-3</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramírez-Tamayo]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<source><![CDATA[Determinación de hormonas sexuales esteroideas en pacientes con micetoma por Nocardia brasiliensis y Actinomadura madurae]]></source>
<year>1998</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Facultad de Medicina, UNAM]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Medications in pregnancy and lactation]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Buhimschi]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Weiner]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Obstet Gynecol]]></source>
<year>2009</year>
<volume>113</volume>
<page-range>166-88</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Evaluating the safety of medications during pregnancy and lactation]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Howland]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[J Psychosoc Nurs Ment Health Serv]]></source>
<year>2009</year>
<volume>47</volume>
<page-range>19-22</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prescribing in pregnancy and during breast feeding: using principles in clinical practice]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Henderson]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Mackillop]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Postgrad Med J]]></source>
<year>2011</year>
<volume>87</volume>
<page-range>349-54</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
