A patient with a mycetomatous foot swelling discharging fine, pale yellow-white grains is confirmed to have actinomycetoma. Which treatment regimen is appropriate?
- A Dapsone combined with trimethoprim-sulfamethoxazole or streptomycin ✓
- B Itraconazole monotherapy for 12 months
- C Amphotericin B deoxycholate followed by fluconazole suppression
- D Terbinafine plus potassium iodide
Correct answer: A. Dapsone combined with trimethoprim-sulfamethoxazole or streptomycin
Explanation
Actinomycetoma is caused by filamentous bacteria such as Nocardia and Actinomadura, so it responds to antibacterial regimens, classically dapsone plus trimethoprim-sulfamethoxazole or streptomycin. Azoles such as itraconazole are reserved for eumycetoma, where Madurella mycetomatis is treated with itraconazole often combined with surgery. Potassium iodide is used for sporotrichosis, not mycetoma.
Reference: Rook's Textbook of Dermatology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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