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Paracoccidioidomycosis (PCM) is an endemic systemic infection in several countries of Latin America. The few registered cases in Mexico most likely do not reflect the real frequency. Disseminate the epidemiological and clinical data of unreported cases of PCM in Mexico from 1972 until 2012 is the aim of this work. Epidemiological and clinical information of non-published cases of PCM was requested from the principal mycological diagnosis centres in Mexico. A total of 93 cases were received. The infection was found predominantly in men (95.7%), peasants (88.5%) and individual between 31 and 60 years of age. Most of the cases were found in tropical areas of the Gulf of Mexico (54.84%) and the Pacific littoral (20.3%). The main sites of dissemination were the oral mucosa (39.38%) and skin (34.05%). The most effective treatments were itraconazole alone and the combination of itraconazole with sulfamethoxazole-trimethoprim. PCM is a subdiagnosed pathology in Mexico. Therefore, adequate training is necessary to determine the current status of this mycosis. [ABSTRACT FROM AUTHOR]

Background: Mycetoma is a chronic, infectious and granulomatous process that affects skin, subcutaneous tissue and bone. It is produced by bacteria (actinomycetoma) or fungus (eumycetoma). In Mexico, the most common agent causing actinomycetoma is Nocardia brasiliensis followed by Actinomadura madurae. For diagnosis it is necessary to identify the etiologic agent (grain) by direct exam, culture, and histopathological study. The gold standard treatment is diaminodifenilsulfona (DDS) plus trimethoprim/sulfamethoxazol (TMP/SMX); in patients with bad-prognosis topography and bone and/or visceral affection, amikacin in added to this treatment; thus, the use of kanamycin in the treatment of actinomycetomas arises from the need of an efficacious and low-cost drug. Objective: To show the efficacy of kanamycin, added to trimethoprim-sulfamethoxazole and DDS, in patients with diagnosis of actinomycetomas due to Nocardia brasiliensis and Actinomadura madurae with topography of bad prognosis and bone and/or visceral damage. Patients and method: At the Mycology Service of the Dermatological Center Dr. Ladislao de la Pascua, 20 patients with Nocardia brasiliensis and Actinomadura madurae actinomycetomas resistant to conventional treatment were studied. To the conventional treatment of TMP-SMX (160-800 mg/12 h) and DDS (100 mg/day) kanamycin sulphate (15 mg/kg/day) was added in cycles of 14 days with interval of one month; depending on the clinical features 2-4 cycles of kanamycin sulfate were administered. Results: The clinical improvement was achieved in all patients in a mean time of three months. Cure, corroborated by a microbiological study, was obtained in 18 patiens (90%) in a mean time of seven months. Radiological improvement was observed in 50%-70% of cases. Conclusions: Considering the good clinical and radiological response in our group of study, we propose this therapeutic scheme as an efficient and safe alternative in the treatment of actinomycetomas, with topography of bad prognosis and bone and/or visceral damage. [ABSTRACT FROM AUTHOR]