Medical treatment of mycetoma depends on its fungal or bacterial etiology. Clinically, these entities share similar features that can confuse diagnosis, causing a lack of therapeutic response due to inappropriate treatment. This review evaluates the response to available antimicrobial agents in actinomycetoma and the current status of antifungal drugs for treatment of eumycetoma.

Mycetoma is a granulomatous infection affecting mainly the feet and lower extremities. It can be caused either by aerobic, branched actinomycetes or by eumycetes. Most cases are found in tropical and subtropical regions. The infection is usually produced by the introduction of the etiologic agents through minor wounds caused by thorns and wood splinters. Clinically the disease begins as small, firm nodules that can enlarge to form extensive lesions with fistulae and abscesses with pus containing granules of the causative microorganisms. Antimicrobials and surgery are used in the management of mycetoma. The actinomycetomas generally respond well to antimicrobials. For eumycetomas, surgery may be required. New therapeutic options for drug-resistant cases are discussed.

BackgroundHuman landing collections are currently the standard method for collecting onchocerciasis vectors in Africa and Latin America. As part of the efforts to develop a trap to replace human landing collections for the monitoring and surveillance of onchocerciasis transmission, comprehensive evaluations of several trap types were conducted to assess their ability to collect Simulium ochraceum sensu lato, one of the principal vectors of Onchocerca volvulus in Latin America.Methodology/Principal FindingsDiverse trap designs with numerous modifications and bait variations were evaluated for their abilities to collect S. Ochraceum s.l. females. These traps targeted mostly host seeking flies. A novel trap dubbed the “Esperanza window trap” showed particular promise over other designs. When baited with CO2 and BG-lure (a synthetic blend of human odor components) a pair of Esperanza window traps collected numbers of S. Ochraceum s.l. females similar to those collected by a team of vector collectors.Conclusions/SignificanceThe Esperanza window trap, when baited with chemical lures and CO2 can be used to collect epidemiologically significant numbers of Simulium ochraceum s.l., potentially serving as a replacement for human landing collections for evaluation of the transmission of O. volvulus.

No association between TLR4 Asp299Gly and pulmonary TB was found. CD14 -159TT is a risk factor for development of pulmonary TB, whereas mCD14/sCD14 and mTLR4 are possible biomarkers for the prognosis for TB disease. CLINICAL TRIAL PROTOCOL ID: SA1168-05.

Clinicians should be aware of nocardiosis in patients with different forms of immunosuppression. The identification of organisms, their patterns of antibiotic susceptibility and the adverse effects related to these drugs must be considered. Treatments can vary from traditional schemes with trimethoprim-sulfamethoxazole to other combination therapies and new antibiotics and treatment modalities depending on the organ or site involved, the severity of infection and the presence of comorbidities.