To the Editor.—
A recent study documents the efficacy of dapsone in the treatment of Nocardia asteroides mycetoma.1 Reference was made to successful treatment of Nocardia mycetoma with cotrimoxazole (Bactrim or Septrin), a combination of 80 mg of trimethoprim and 400 mg of sulfamethoxazole, which acts synergetically. Our case report and accompanying references suggest that co-trimoxazole might be a treatment of choice in N brasiliensis mycetoma.
Report of a Case.—
A 49-year-old woman stepped on a rusty nail while vacationing in Hawaii in 1970. The nail was thought to have penetrated to a depth of approximately 1 cm. The lesion promptly healed. In July 1973, she noted two painful red nodules on the distal surface of the same foot. Her family physician prescribed 500-mg ampicillin capsules four times per day for three weeks, and then 250-mg tetracycline capsules four times per day for five days. By September,
Maibach HI, Gorham W, Aly R. Nocardia brasiliensis Mycetoma: Treatment With Co-trimoxazole. Arch Dermatol. 1975;111(5):656. doi:10.1001/archderm.1975.01630170114018