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The First Autochthonous Case of Actinomycetoma in a Bedouin Patient in the Israeli Negev Region.

Am J Trop Med Hyg

January 2025

Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel.

We report the first autochthonous case of actinomycetoma in a Bedouin patient from Israel's Negev Region. The patient presented with plantar and interdigital (web) nodular lesions. The time to diagnosis from the first medical contact was 4 years, and several treatment modifications were made until a satisfactory clinical response was achieved.

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Introduction: Mycetoma is a chronic granulomatous infection, common throughout tropical regions, and is considered a neglected disease that mostly affects impoverished populations. Mycetoma is divided into eumycetoma, caused by fungi, and actinomycetoma, caused by filamentous bacteria. Clinical presentation is distinctive, and making the diagnosis is usually not difficult; however, access to safe and effective treatments is a major challenge.

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Introduction: Deep mycoses acquired by penetrating trauma to the skin can have varied and sometimes atypical morphological presentations resulting in diagnostic dilemmas and delay in treatment onset. Histopathology can be a useful tool in not only diagnosing but also differentiating various deep mycoses.

Aims And Objectives: To observe various morphological presentations and histopathological features of deep fungal infections.

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Tropicoporus tropicalis (formerly Phellinus tropicalis) is a saprophytic basidiomycete that has been implicated in refractory mycoses in humans, particularly in patients with chronic granulomatous disease. Despite its clinical significance, T. tropicalis is an under-recognised cause of eumycetoma, with no prior reports available.

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