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Immigration Brings New Pathology with No Standardized Treatment Protocol

Madura Foot Case Studies Phialemonium and Phaeoacremonium

Tara L. Harrington DPM, MBA, MHA1, Denten Eldredge DPM2, and Erica K. Benson DPM, MS3
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  • 1 Intermountain Medical Center Surgery, Salt Lake City, UT. Dr. Harrington is now with the Northern Ohio Foot and Ankle Foundation Reconstruction Fellowship, Concord, OH.
  • | 2 Western University of Health Sciences, College of Podiatric Medicine, Pomona, CA. Dr. Eldredge is now with Reconstruction Foot and Ankle, Department of Orthopedics, Podiatry, and Sports Medicine, Kaiser Permanente Central Valley Region, Stockton, CA.
  • | 3 St. Mary's Medical Center, San Francisco, CA.
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Madura foot is an uncommon invasive soft-tissue infection that foot and ankle specialists encounter. We present two rare cases of Phialemonium and Phaeoacremonium fungi infections of the foot diagnosed in northern California to inform physicians on the presentation and current treatment options for this unique pathology. The two cases presented outline the clinical presentations, diagnostic data, and surgical and antimicrobial interventions. There is a concentration on the antimicrobial options depending on which of the over 20 species is encountered. The pertinent literature and supporting data are reviewed to create an outline for discussion of treatment protocols when faced with these emerging opportunistic infections.

Corresponding author: Tara L. Harrington, DPM, MBA, MHA, Northern Ohio Foot and Ankle Foundation Reconstruction Fellowship, 38401 Mentor Ave, Unit 1204, Willoughby, OH 44094. (E-mail: t.harrington.dpm@gmail.com)