Giant eumycetoma gluteal region: excision and V-Y flap advancement

Abstract

Eumycetoma (“mycotic mycetoma”) is a chronic subcutaneous fungal infection of the skin and soft tissue, most often affecting the lower extremity (typically a single foot). Eumycetomas are usually confined to subcutaneous tissues but can involve fascia, bone, and regional lymph nodes via contiguous dissemination. We hereby report a case mycetoma of gluteal region, an unusual site of presentation.

Management of Eumycetoma

“…Socioeconomic status should be taken into consideration, minding that eumycetoma is closely related to occupations with high exposure to soil, such as farmers. 11,12,19 A general physical examination covers the general condition and vital signs. It is essential to carefully evaluate the general condition, keeping in mind the possibility of malignancy.…”

“…The bones are not usually involved. 3,11,12,19 Additional examination is done to detect mycetoma granules, which is the key characteristic in the diagnosis, and it is usually excreted through an open sinus. Direct examination is done by directly evaluating the granules in the pus.…”

“…On late phases, eumycetomas might cause complications, namely secondary bacterial infection that induces bacteremia and septicemia, leading to death. 3, 10,11 A recently published prospective study investigated the prognostic factors for recovery and amputation. The study involved 1242 patients with eumycetoma and 302 patients with actinomycetoma.…”

“…Several studies reported that most patients had delays in seeking medical care due to the poor socio-economic condition, resulting in suboptimal care in health facilities. 7,[9][10][11] This article discusses various aspects of eumycetoma, including its epidemiology, etiology, pathogenesis, classification, clinical feature, diagnosis, differential diagnosis, and therapy.…”

Reconstructive Surgery for Mycetoma: Is There a Need to Establish an Algorithm?

“…Nevertheless, the decision of amputation may be undeniably difficult in some cases as it can be a lifesaving procedure 39 A local V-Y flap was advanced to cover a large gluteal defect following local resection of an eumycetoma in the gluteal region. 49 A latissimus dorsi flap was transferred to cover a large chest wall defect following an excision of mycetoma lesion. 50…”