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Actinomycosis of the amputation stump

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Author(s): Sharma Y | Sawhney M | Malaviya A | Singh N

Journal: Indian Journal of Dermatology, Venereology and Leprology
ISSN 0378-6323

Volume: 69;
Issue: 7;
Start page: 41;
Date: 2003;

Keywords: Actinomycosis | Amputation stump

ABSTRACT
An 85-year-old male presented with erythematous and tender nodular lesions, since last 15 years, some arranged in a linear fashion, over the anterolateral aspect of 40 year old below knee amputation stump. There were no discharging sinuses. X-ray of the amputation stump showed chronic osteomyelitis of the left tibia. Skin biopsy form one of the nodules showed a solitary intradermal granule with gram-positive filamentous bacteria. Both aerobic as well as anaerobic culture from the nodule did not reveal any growth. Diagnosed as a case of actionomycosis of the amputation stump, with a possible underlying chronic actinomycotic osteomyelitis of the left tibia. Patient was treated with intramuscular penicillin, followed by oral doxycycline and dapsone. The nodular lesions disappeared after five months of follow-up. Chronic osteomyelitis of tibia of below knee amputation stump due to Actinomycetes with granlomatous involvement of the overlying skin, presenting 25 years after sustaining injury and persisting for the next 15 years, without any draining sinuses, is an interesting feature in this case.
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