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October 1986

Actinomycetoma Caused by Streptomyces somaliensis

Author Affiliations

Universidad Central de Venezuela Instituto de Medicina Tropical Seccion de Micologia Apartado 2.109 Caracas, Venezuela

Arch Dermatol. 1986;122(10):1097-1098. doi:10.1001/archderm.1986.01660220011002

To the Editor.—  Certain points in the article by Drs Sindhuphal et al1 in the October 1985 Archives merit useful discussion: (1) The mycetoma had been active before the patient entered Texas. Where had the infection been contracted? Perhaps in Mexico, which is geographically a continuum with Texas? (2) Size, hardness and surface quality of the grains are not mentioned. The statement that "The biopsy specimen showed gram-positive, non-acid-fast granules with distinct borders" looks somewhat inaccurate, because gram staining is not suitable for granules but for actinomycetic hyphae. characteristic of a well-known entity, ie, the mycetoma by Streptomyces somaliensis, whose grains are hard-cemented and brittle, becoming fragmented when impacted by a microtome blade, then rolling up with the tissue section. The bodies seen in Figs 2 and 3 are mere residual parcels of grains in the breakdown process. In any case, some structures fixed by hematoxylin that are visible

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