SLR- December 2013- Katy Freeland and Matthew Britt
Reference: Pickert A, Nguyen X. “Madura Foot.” The New England Journal of Medicine. 366(1):e2. 2012.
Scientific Literature Review
Reviewed By: Katherine Freeland, DPM, and Matthew Britt, DPM
Residency Program: Hunt Regional Medical Center, Greenville, TX
Podiatric Relevance: Madura foot is a bacterial infection that occurs in the foot. As foot and ankle surgeons, we need to be able to appropriately diagnose it and treat it successfully.
Methods: This case report presents and reviews a 40-year-old female who presented with painful, draining nodules on her right foot that had been present for 11 years. These nodules were treated in Mexico previously with an unknown antibiotic without resolution. Examination of the foot revealed sinus tracts, as well as draining red nodules.Results: Culture and punch biopsy of the lesions did not grow any organisms, however, the pathology did come back as non-acid-fastfilamentous actinbacteria. The actinomyces (actinomycotic myecetoma) or true fungi (eumycotic mycetoma) was treated with doxycycline for eight months and was successful.
Conclusion: Madura foot, or infection with actinomyces or myectoma, is a bacterial infection that needs to be diagnosed properly for successful resolution and treatment. A biopsy with histological examination is the key in identifying the organism responsible for the infection. Patients present with pain, difficulty weight bearing secondary to the pain, and draining lesions on multiple areas of the foot. Treatment can be accomplished with the application of the proper antibiotic for an extended period of time.