{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T04:38:19Z","timestamp":1770698299696,"version":"3.49.0"},"reference-count":22,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:00:00Z","timestamp":1770508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Mycetoma is a chronic infectious disease caused by bacteria or fungi which typically affects the skin, deep tissues, and bones. This case involves bone mycetoma in an immunocompetent patient, marking the first known instance of actinomycetoma caused by Gordonia rubripertincta. Case Report: A 25-year-old male presented with severe pain and deformity in his left foot, symptoms that began five years prior after stepping on a wire. Initial surgery provided temporary relief, but symptoms worsened over time. Doxycycline treatment was ineffective. Skin biopsies were performed. The patient was diagnosed with actinomycetoma, with Gordonia rubripertincta identified in culture. Although initial improvement was observed with amoxicillin\u2013clavulanate treatment, the condition later worsened, requiring long-term penicillin therapy and eventual surgical excision. Despite treatment, symptoms persisted, leading to a bone biopsy that showed no microorganism growth. A six-week course of ampicillin\u2013sulbactam and ciprofloxacin, along with offloading, decreased pain and stabilized radiological findings. Conclusion:\u00a0Gordonia infections mean there is no universally established treatment protocol. This case underscores the diagnostic and therapeutic challenges associated with mycetoma, particularly in non-tropical regions.<\/jats:p>","DOI":"10.3390\/diagnostics16040509","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T10:45:31Z","timestamp":1770633931000},"page":"509","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Actinomycetoma Caused by Gordonia rubripertincta: Case Report"],"prefix":"10.3390","volume":"16","author":[{"given":"Rita","family":"Siksniute","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Lithuanian University of Health Sciences, LT-47116 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vilune","family":"Martinkiene","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Lithuanian University of Health Sciences, LT-47116 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9312-5528","authenticated-orcid":false,"given":"Rokas","family":"Jurkonis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justinas","family":"Stucinskas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Valatkeviciene","sequence":"additional","affiliation":[{"name":"Department of Radiology, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5177-4485","authenticated-orcid":false,"given":"Silvija","family":"Kiveryte","sequence":"additional","affiliation":[{"name":"Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania"},{"name":"Laboratory of Microbiology, Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Marcinkeviciene","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Centre of Laboratory Medicine, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9114-9537","authenticated-orcid":false,"given":"Danguole","family":"Vaznaisiene","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Lithuanian University of Health Sciences, LT-47116 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024, April 09). Mycetoma. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/mycetoma."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"332","DOI":"10.4103\/ijd.IJD_476_16","article-title":"Mycetoma: An Update","volume":"62","author":"Relhan","year":"2017","journal-title":"Indian J. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Siksniute, R., Martinkiene, V., Jurkonis, R., Stucinskas, J., Valatkeviciene, K., and Vaznaisiene, D. (2024, January 21\u201322). First Case of Actinomycetoma Caused by Gordonia rubripertincta. Proceedings of the 11th Annual Oxford Bone Infection Conference (OBIC 2024), Oxford, UK. Available online: https:\/\/obic.org.uk\/wp-content\/uploads\/2024\/03\/OBIC2024_programme-and-abstract-book.pdf.","DOI":"10.2139\/ssrn.4931876"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hao, X., Cognetti, M., Burch-Smith, R., Mejia, E.O., and Mirkin, G. (2022). Mycetoma: Development of Diagnosis and Treatment. J. Fungi, 8.","DOI":"10.3390\/jof8070743"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Fahal, A.H., and Bakhiet, S.M. (2023). Mycetoma and the environment. PLoS Neglected Trop. Dis., 17.","DOI":"10.1371\/journal.pntd.0011736"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Fahal, A.H., Suliman, S.H., and Hay, R. (2018). Mycetoma: The Spectrum of Clinical Presentation. Trop. Med. Infect. Dis., 3.","DOI":"10.3390\/tropicalmed3030097"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s12223-017-0491-1","article-title":"Gordonia: Isolation and identification in clinical samples and role in biotechnology","volume":"62","author":"Andalibi","year":"2017","journal-title":"Folia Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"188","DOI":"10.3855\/jidc.1770","article-title":"Hickman catheter-related bacteremia caused by Gordonia sputi in a patient with breast cancer","volume":"6","author":"Kofteridis","year":"2011","journal-title":"J. Infect. Dev. Ctries"},{"key":"ref_9","first-page":"e005067","article-title":"Sternal wound infection caused by Gordonia bronchialis: Identification by MALDI-TOF MS","volume":"3","author":"Calvo","year":"2016","journal-title":"JMM Case Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.nefro.2016.05.015","article-title":"Dialysis catheter related bacteriemia by Gordonia rubropertincta and Sputi in two hemodialysis patients","volume":"36","author":"Ortega","year":"2016","journal-title":"Nefrolog\u00eda"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Franczuk, M., Klatt, M., Filipczak, D., Zabost, A., Parniewski, P., Kuthan, R., Jakubowska, L., and Augustynowicz-Kope\u0107, E. (2022). From NTM (Nontuberculous mycobacterium) to Gordonia bronchialis-A Diagnostic Challenge in the COPD Patient. Diagnostics, 12.","DOI":"10.3390\/diagnostics12020307"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3443","DOI":"10.1128\/JCM.01449-13","article-title":"Gordonia bacteremia","volume":"51","author":"Ramanan","year":"2013","journal-title":"J. Clin. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e03262023","DOI":"10.1590\/0037-8682-0326-2023","article-title":"Case report: Mycetoma caused by Gordonia soli","volume":"56","author":"Carneiro","year":"2023","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100658","DOI":"10.1016\/j.nmni.2020.100658","article-title":"Actinomycetoma caused by Gordonia westfalica: First reported case of human infection","volume":"34","author":"Gueneau","year":"2020","journal-title":"New Microbes New Infect."},{"key":"ref_15","first-page":"e90","article-title":"Image Gallery: Actinomycetoma caused by Gordonia terrae in an immunocompetent woman","volume":"179","author":"Wang","year":"2018","journal-title":"Br. J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1111\/j.1445-5994.1988.tb00182.x","article-title":"Lung infection caused by Rhodococcus","volume":"18","author":"Hart","year":"1988","journal-title":"Aust. N. Z. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.clindermatol.2006.05.011","article-title":"Mycetoma","volume":"25","author":"Welsh","year":"2007","journal-title":"Clin. Dermatol"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Frantsuzova, E., Bogun, A., Vetrova, A., and Delegan, Y. (2022). Methods of Identifying Gordonia Strains in Clinical Samples. Pathogens, 11.","DOI":"10.3390\/pathogens11121496"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"968","DOI":"10.3923\/pjbs.2020.968.972","article-title":"Characterization of Foot Mycetoma Using Sonography and Color Doppler Imaging","volume":"23","author":"Gameraddin","year":"2020","journal-title":"Pak. J. Biol. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2901","DOI":"10.1128\/jcm.31.11.2901-2906.1993","article-title":"Enzyme-linked immunosorbent assay for serological diagnosis of Nocardia brasiliensis and clinical correlation with mycetoma infections","volume":"31","author":"Welsh","year":"1993","journal-title":"J. Clin. Microbiol."},{"key":"ref_21","first-page":"E11","article-title":"Actinomycetoma: An update on diagnosis and treatment","volume":"99","author":"Arenas","year":"2017","journal-title":"Cutis"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Suleiman, S.H., Wadaella, E.S., and Fahal, A.H. (2016). The Surgical Treatment of Mycetoma. PLoS Neglected Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004690"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/4\/509\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T11:00:53Z","timestamp":1770634853000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/4\/509"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,8]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["diagnostics16040509"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16040509","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,8]]}}}