Madurella mycetomatis causing eumycetoma medical treatment: The challenges and prospects

Elkheir, Lamis Yahia Mohamed; Haroun, Rayan; Mohamed, Magdi A.; Fahal, Ahmed H.

doi:10.1371/journal.pntd.0008307

Cited by 24 publications

(22 citation statements)

References 94 publications

(141 reference statements)

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“…Newer drugs fosravuconazole, a prodrug of ravuconazole and Isavuconazole have shown promising results in in-vitro studies and are being clinically assessed in a double-blind clinical trial on eumycetoma. 13 Echinocandins and amphotericin B, though useful in other deep fungal infections have poor in-vitro activity against Madurella mycetomatis and are not used. 1 However, insertion of amphotericin B-impregnated absorbable calcium sulfate beads (Stimulan) into the bony defects after surgical debulking to increase the clinical outcome showed good clinical outcome with lesser side effects.…”

Section: Treatment Of Eumycetomamentioning

confidence: 99%

Section: Treatment Of Mycetomamentioning

confidence: 99%

“…Though the search for newer and more effective drugs for eumycetoma is going on, the response to existent therapies can be enhanced for a better therapeutic result: an oral solution of itraconazole in a cyclodextrin vehicle has increased oral bioavailability as compared to itraconazole capsules and may prove to be more efficacious mainly in the pediatric population. 13 Also, effective and safe serum levels of certain drugs like itraconazole can be achieved via therapeutic drug monitoring (TDM) techniques such as high-performance liquid chromatography (HPLC) and mass spectrometry (MS). 13 Addition of NSAIDs with systemic antifungals has shown good clinical outcome in refractory mycetoma (duration>20 years) with no relapse during 8 years of follow-up.…”

Section: Recommendations To Improve Currently Available Treatments In Eumycetomamentioning

confidence: 99%

“… 13 Also, effective and safe serum levels of certain drugs like itraconazole can be achieved via therapeutic drug monitoring (TDM) techniques such as high-performance liquid chromatography (HPLC) and mass spectrometry (MS). 13 Addition of NSAIDs with systemic antifungals has shown good clinical outcome in refractory mycetoma (duration>20 years) with no relapse during 8 years of follow-up. 15 Similarly, combining oral prednisolone with antifungals and sulfamethoxazole plus trimethoprim was also reported to enhance the clinical outcome of patients without causing additional side effects.…”

Section: Recommendations To Improve Currently Available Treatments In Eumycetomamentioning

confidence: 99%

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Clinical Features of Mycetoma and the Appropriate Treatment Options

Agarwal¹,

Jagati²,

Rathod³

et al. 2021

RRTM

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Mycetoma is a chronic, suppurative and debilitating granulomatous infection seen mainly in tropical and subtropical areas and is now declared as a neglected tropical disease by the World Health Organization. The clinical diagnosis is usually characterized by a classical triad of localized swelling, underlying sinus tracts, and production of grains or granules, but unusual presentations are also seen. It is classified into eumycetoma caused by the fungus, and actinomycetoma caused by the bacteria. The clinical presentation of both is almost similar and a definite diagnosis is essential before starting the treatment as it differs for both. Surgical debulking followed by a prolonged course of medical therapy now forms the mainstay of treatment due to the long course of the disease and suboptimal response. This review focuses on the various usual as well as unusual clinical presentations of mycetoma, established treatment regimens as well as recent changes in the mode of administration of drugs and newer drugs for mycetoma.

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Section: Treatment Of Eumycetomamentioning

confidence: 99%

Section: Treatment Of Mycetomamentioning

confidence: 99%

Section: Recommendations To Improve Currently Available Treatments In Eumycetomamentioning

confidence: 99%

Section: Recommendations To Improve Currently Available Treatments In Eumycetomamentioning

confidence: 99%

See 2 more Smart Citations

Clinical Features of Mycetoma and the Appropriate Treatment Options

Agarwal¹,

Jagati²,

Rathod³

et al. 2021

RRTM

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“…Several studies suggested a possible role of animal dung in causing mycetoma as some organisms were isolated from the dung, which may act as a reservoir for them [21,[30][31][32], allowing the direct transmission to the human. Most of the individuals living in rural areas are in direct contact with animals such as cattle, donkeys, dogs, sheep and chickens.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Clinical epidemiological characteristics of mycetoma in Eastern Sennar locality, Sennar State, Sudan

et al. 2021

Self Cite

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Mycetoma epidemiological features remain uncharacterised. Few studies have been conducted in a community-based setting to explore the epidemiological features and risk factors for mycetoma in Sudan. To bridge this gap, this study was conducted in Eastern Sennar Locality, Sennar State, Sudan, to report the clinical, epidemiological characteristics of mycetoma patients and the disease burden in the state. We used cluster sampling; sixty villages were randomly selected across the locality’s five administrative units, and a household-to-household survey was conducted. We collected data using pre-designed questionnaires at the community, household, and individual levels. We performed descriptive analyses of the data and produced prevalence maps using ArcGIS 10.5 ([ESRI] Inc., Redlands CA, USA). A total of 41,176 individuals were surveyed, and 359 mycetoma patients were identified. The overall prevalence of mycetoma was 0.87% (95%CI = 0.78–0.97%), the prevalence among males was 0.83% (95%CI = 0.71–0.96%), and females 0.92% (95% CI = 0.79–1.06%). Individuals in the age group 31–45 years had the highest prevalence among the different age groups (1.52%, 95% CI = 1.23–1.86%). The prevalence map showed patients clustered within the central and north-eastern part of the locality, while villages in the south-western part had few or no cases. In conclusion, this clinical epidemiological study is pioneering and shows that mycetoma is prevalent in certain parts of Sudan. This data obtained will support the design of measures to reduce the disease burden in the state. The survey procedures and protocols can be adopted for further studies in Sudan and beyond.

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Antifungal Activity of Natural Naphthoquinones and Anthraquinones against Madurella mycetomatis

Todd

Sande

et al. 2023

Chemistry & Biodiversity

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Eumycetoma, the fungal form of the neglected tropical disease mycetoma, is a crippling infectious disease with low response rates to currently available antifungal drugs. In this study, a series of natural naphthoquinones and anthraquinones was evaluated for their activity against Madurella mycetomatis, which is the most common causative agent of eumycetoma. The metabolic activity of Madurella mycetomatis as well as the viability of Galleria mellonella larvae upon treatment with quinones was investigated. Several hydroxy‐substituted naphthoquinones exhibited activity against Madurella mycetomatis. In particular, naphthazarin (5,8‐dihydroxy‐1,4‐naphthoquinone) was identified as a considerably active antifungal compound against Madurella mycetomatis (IC50=1.4 μM), while it showed reduced toxicity to Galleria mellonella larvae, which is a well‐established in vivo invertebrate model for mycetoma drug studies.

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Madurella mycetomatis causing eumycetoma medical treatment: The challenges and prospects

Cited by 24 publications

References 94 publications

Clinical Features of Mycetoma and the Appropriate Treatment Options

Clinical Features of Mycetoma and the Appropriate Treatment Options

Clinical epidemiological characteristics of mycetoma in Eastern Sennar locality, Sennar State, Sudan

Antifungal Activity of Natural Naphthoquinones and Anthraquinones against Madurella mycetomatis

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