The authors report their own experience from 200 cases and they consider the matter from the point of a surgeon operating in a small medical unit in Africa. The clinical and biological aspects are described; the importance and the difficulties of appreciating the real spreading of infection are emphasized. Conventional radiology is of major value. The biological diagnosis may give way to a medical treatment with DDS and sulfamethoxypyridazine in cases due to actinomycetes with red or yellow granules; but in fungic cases fungicid drugs proved to be inefficient. Surgery is still an important component of the treatment. Its tactics are discussed according to the germ, the localization, the extension and also to the social and psychological status, but it is hoped that more sanitary education will reduce its preponderence in making possible earlier diagnosis and treatment.
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