Eosinophilic peripheral arteritis: peripheral arterial occlusion with eosinophilia

97 similar and could only be differentiated by the characteristics of the colonies obtained by culture. (3) The thoracic and abdominal location is related to the rural day-to-day routine of carrying plants or wood without adequate protection; consequently the skin suffers numerous traumas that represent multiple bacterial inocula [1, 3, 4, 6]. (4) The difficulty in treating our case was related to the resistance of A. madurae to conventional treatment regimens, to which N. brasiliensis is sensitive. The response to treatment with two cycles of amikacin and trimethoprim sulfamethoxazole for one year was not effective in this case, therefore salvage therapy with amoxicillin/clavulanate was attempted and the expected response was observed [9]. In an earlier case, we reported our experience with this scheme as a rescue therapy when conventional therapy failed [10]. We recommend the use of the combined regimen amoxicillin/clavulanate with streptomycin in similar cases. This therapeutic combination presented favourable results in our patient, achieving clinical and mycological cure. (5) The initial anaemia was probably related to chronic infection and returned to normal a few months after the treatment. To our knowledge, this is the first reported case of these two aetiological agents producing actinomycetoma and presenting different clinical and biological behaviours, with different response to treatment.