In a case of actinomycotic mycetoma caused by Streptomyces madurae with extensive destruction of the bone, the foot was saved from amputation by appropriate antibiotic therapy given for a period of 2 1/2 years. Periodic x-ray examinations gave a valuable guide to the progress of the patient. Chemotherapy and antibiotics play an important role in the present day management of mycetoma. Cutaneous amelioration is not the criteria for cure. The bone restoration that occurs much later should be the guide for the duration of therapy.
Kamalam A, Subramaniyam P, Augustine SM, Thambiah AS. Restoration of Bones in Mycetoma. Arch Dermatol. 1975;111(9):1178-1180. doi:10.1001/archderm.1975.01630210094014