Mycetoma Caused by Madurella mycetomatis: A Completely Neglected Medico-social Dilemma

Belkum, Alex van; Fahal, Ahmed Hassan; Sande, Wendy W. J. van de

doi:10.1007/978-1-4614-4726-9_15

Cited by 41 publications

(31 citation statements)

References 56 publications

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“…Due to the predilection for feet, mycetoma control could be achieved by using appropriate footwear and clothing that protects the limbs. However, it should be emphasized that people living in endemic regions sometimes wear open-toed shoes, mainly due to the warm climate and therefore are less protected against potential trauma [1], [5], [20], [21].…”

Section: Discussionmentioning

confidence: 99%

Mycetoma: Experience of 482 Cases in a Single Center in Mexico

et al. 2014

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Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013). A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11%) were actinomycetomas and 38 cases (7.88%) were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3∶1. The mean age was 34.5 years old (most ranged from 21 to 40 years). The main affected localization was lower and upper limbs (70.74% and 14.52% respectively). Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported). The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%). Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21%) and Actinomadura madurae (8.7%); meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii) were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

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Section: Discussionmentioning

confidence: 99%

Mycetoma: Experience of 482 Cases in a Single Center in Mexico

et al. 2014

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“…Our case was a peculiar one with very few superficial signs of the disease but with massive deep tissue destruction. The progress of mycetoma depends on the site involved, the causative organism and probably the hosts defenses and the incubation time is not well defined [2]. In our case, the patients ought tertiary health care facility attention only when the forearm became incapacitated with the deeper tissue destruction.…”

Section: Discussionmentioning

confidence: 72%

“…Eumycetoma is a common but completely neglected disease even in recent times [2]. It usually affects adult males.…”

Section: Discussionmentioning

confidence: 99%

“…The grains in tissues accumulate extracellular cement with melanin which acts as a barrier protecting the fungus from the host immunity and antifungal agents. The natural habitat of this fungus is still an enigma but its DNA has been detected in plant and soil [2]. The most effective treatment is possible only when cases are diagnosed early in the course of disease.…”

Section: Discussionmentioning

confidence: 99%

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Unusual Presentation of Madurella Mycetomatis Mycetoma in a Paediatric Patient in India

Tendolkar¹

2016

MOJCR

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Eumycetoma due to Madurella mycetomatis is of worldwide occurrence. It usually presents with signs of tumefaction, sinuses and grains which are the hallmarks in diagnosis of the disease. The present case was an eight year old boy admitted with moderate swelling of the forearm with a discharging sinus. The swelling had developed over a four month period. He gave history of trauma one year back to the site. He also had fever for two months. Imaging studies showed large cystic lesions in the bone. On surgical exploration it was observed that a large mass of compacted black grains (5cm X4cm) was filling the space between the radius and ulna bones. A mycological examination of the black grains revealed fungal hyphae and culture showed growth of Madurella mycetomatis. An extensive surgical debridement and voriconazole treatment for 6 weeks relieved the clinical symptoms but there was little radiological improvement. This case represents a rare presentation of mycetoma with a rapid progression of the disease over a few months, not commonly seen with eumycotic agents. The young age of the patient and the site were unusual findings. The external signs were mild and disproportionate to the extensively destructive disease seen underneath. These findings highlight the importance of an early diagnosis to prevent the devastation caused by this relentless infection which may be especially challenging in cases like this which present with unusual features.

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“…Eumycetomas, those caused by true fungi, include members of the Madurella , Pseudallescheria , Acremonium , and several other genera [ 13 ]. Actinomycetomas are caused by Nocardia , Actinomadura , Actinomyces , and Streptomyces species of bacteria.…”

Section: Mycetomamentioning

confidence: 99%