Mycetoma: a unique neglected tropical disease

Zijlstra, Eduard E.; Sande, Wendy W. J. van de; Welsh, Oliverio; Mahgoub, El Sheikh; Goodfellow, Michael; Fahal, Ahmed H.

doi:10.1016/s1473-3099(15)00359-x

Cited by 267 publications

(361 citation statements)

References 110 publications

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“…During this period, 272 mycetoma cases were reported (Table 4). This number is smaller than that observed in Sudan and Mexico [8, 9,10]. For instance, in Mexico, where 483 mycetoma cases were diagnosed at a single hospital during the same period [11].…”

Section: Discussion and Review Of The Literaturementioning

confidence: 93%

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Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

et al. 2017

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Mycetoma is caused by the subcutaneous inoculation of filamentous fungi or aerobic filamentous bacteria that form grains in the tissue. The purpose of this study is to describe the epidemiologic, clinic, laboratory, and therapeutic characteristics of patients with mycetoma at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, between 1991 and 2014. Twenty-one cases of mycetoma were included in the study. There was a predominance of male patients (1.3:1) and the average patient age was 46 years. The majority of the cases were from the Southeast region of Brazil and the feet were the most affected anatomical region (80.95%). Eumycetoma prevailed over actinomycetoma (61.9% and 38.1% respectively). Eumycetoma patients had positive cultures in 8 of 13 cases, with isolation of Scedosporium apiospermum species complex (n = 3), Madurella mycetomatis (n = 2) and Acremonium spp. (n = 1). Two cases presented sterile mycelium and five were negative. Six of 8 actinomycetoma cases had cultures that were identified as Nocardia spp. (n = 3), Nocardia brasiliensis (n = 2), and Nocardia asteroides (n = 1). Imaging tests were performed on all but one patients, and bone destruction was identified in 9 cases (42.68%). All eumycetoma cases were treated with itraconazole monotherapy or combined with fluconazole, terbinafine, or amphotericin B. Actinomycetoma cases were treated with sulfamethoxazole plus trimethoprim or combined with cycles of amikacin sulphate. Surgical procedures were performed in 9 (69.2%) eumycetoma and in 3 (37.5%) actinomycetoma cases, with one amputation case in each group. Clinical cure occurred in 11 cases (7 for eumycetoma and 4 for actinomycetoma), and recurrence was documented in 4 of 21 cases. No deaths were recorded during the study. Despite of the scarcity of mycetoma in our institution the cases presented reflect the wide clinical spectrum and difficulties to take care of this neglected disease.

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Section: Discussion and Review Of The Literaturementioning

confidence: 93%

“…Mycetoma treatment is challenging and usually requires long periods of drug therapy with or without surgical procedures (complete excision of the lesion, bone curettage, amputation) [1,5,8,10]. Itraconazole is the most common antifungal agent used for eumycetoma treatment [2].…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

et al. 2017

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“…Por su parte, los eumicetomas producen pocas fístu-las, el compromiso óseo suele ser tardío y con grandes cavidades, y la diseminación linfática es ocasional; en el estudio macroscópico, la lesión es bien defina y presenta cápsula 1 . Sin embargo, la clínica no es suficiente para hacer la distinción entre estas patologías, por lo cual debe aislarse el microorganismo para confirmar la etiología del micetoma.…”

Section: Diagnóstico Diferencialunclassified

“…El micetoma es una enfermedad infecciosa crónica, subcutánea, de tipo granulomatoso, endémica en regiones tropicales y subtropicales, que puede ser causada por más de 56 microorganismos diferentes, incluyendo bacterias, denominándose entonces actinomicetoma, y hongos, denominándose entonces eumicetoma 1 . En esta revisión nos centraremos en el eumicetoma.…”

Section: Introductionunclassified

Eumicetoma: actualidades y perspectivas

Arenas

Vega-Memije

Rangel-Gamboa

2017

GMM

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“…Actinomycetoma is a chronic subcutaneous infection 2. Most cases are caused by Nbr 3. Treatment with trimethoprim-sulfamethoxazole and amikacin for 5–20 weeks cures 90% of the Nocardia spp.…”

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confidence: 99%