The usual treatments are chemotherapy for actinomycetomas and surgery and/or chemotherapy for eumycetomas. I have been unable to find any systematic reviews of treatment and there are no controlled clinical trials. Good responses to drugs such as sulphonamides and sulphones as well as co-trimoxazole have been reported in the management of actinomycetomas.5,6 Treatment of eumycetoma with chemotherapy produces unpredictable results4,6 and recovery is unusual. Radical surgery including limb amputation is curative in most cases.

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