Local chemotherapy omaduromycosis caused by Monosporium apiospermum.

Localized deep-seated fungus infections are only occasionally seen in the temperate climate of this country. Infection with Monosporium apiospermum is especially uncommon, but does occur. 1 Unlike mycetomatous disease caused by other fungi, infections with M apiospermum respond poorly to chemotherapy. 1,2 Destructive excision or amputation of involved tissues is usually necessary. A patient, who had maduromycosis of the foot caused by M apiospermum but had refused amputation, provided a unique opportunity to evaluate the effectiveness of a new therapeutic approach to localized fungus infection: high dosage, local, parenterally administered chemotherapy. The relative effectiveness and safety of two different antifungal drugs, and the usefulness of dimethyl sulfoxide (DMSO) as a vehicle for local parenterally administered therapy were explored in this patient. The chronicity of the infection and complicating bacterial osteomyelitis precluded eventual salvage of a functional foot. Nevertheless, the studies accomplished confirmed the effectiveness of local parenterally administered therapy and