TY - JOUR
T1 - Mycetoma in Timor-Leste and first report of nocardiosis
AU - Townell, Nicola
AU - Locke, Thomas
AU - Gibbons, Margaret
AU - Murphy, Dan
AU - Francis, Joshua
AU - Nourse, Clare
PY - 2018
Y1 - 2018
N2 - Mycetoma is a neglected tropical disease with an unknown global burden. Although considered endemic to South-east Asia, it has not previously been reported from Timor-Lest. We describe two cases in Timor-Leste, highlighting the challenges surrounding microbiological diagnosis and management shared by many low to middle-income countries. As characteristically described, both patients lived rurally and presented late with marked soft tissue involvement and multiple draining sinuses following a prolonged period of high morbidity. Nocardia brasiliensis, a beaded-branched, modified acid-fast, gram-positive bacilli, was isolated and confirmed by molecular testing in the first case. The causative organism in the second case could not be confirmed due to limited microbiological capabilities. Due to limited local laboratory capabilities, Nocardia spp. infection cannot be routinely confirmed in Timor-Leste. However, the microbiology laboratory is essential for the successful diagnosis and management of Mycetoma. In both cases, medical therapy alone resulted in cure and favorable outcomes, although supply of antibiotic remains an ongoing resource issue.
AB - Mycetoma is a neglected tropical disease with an unknown global burden. Although considered endemic to South-east Asia, it has not previously been reported from Timor-Lest. We describe two cases in Timor-Leste, highlighting the challenges surrounding microbiological diagnosis and management shared by many low to middle-income countries. As characteristically described, both patients lived rurally and presented late with marked soft tissue involvement and multiple draining sinuses following a prolonged period of high morbidity. Nocardia brasiliensis, a beaded-branched, modified acid-fast, gram-positive bacilli, was isolated and confirmed by molecular testing in the first case. The causative organism in the second case could not be confirmed due to limited microbiological capabilities. Due to limited local laboratory capabilities, Nocardia spp. infection cannot be routinely confirmed in Timor-Leste. However, the microbiology laboratory is essential for the successful diagnosis and management of Mycetoma. In both cases, medical therapy alone resulted in cure and favorable outcomes, although supply of antibiotic remains an ongoing resource issue.
KW - Mycetoma
KW - Nocardia
KW - Timor-Leste
UR - http://www.scopus.com/inward/record.url?scp=85094962534&partnerID=8YFLogxK
U2 - 10.4081/idr.2018.7804
DO - 10.4081/idr.2018.7804
M3 - Article
C2 - 30662693
AN - SCOPUS:85094962534
VL - 10
SP - 64
EP - 66
JO - Infectious Disease Reports
JF - Infectious Disease Reports
SN - 2036-7430
IS - 3
ER -