Mycetoma in Children: Experience With 15 Cases

Bonifáz, Alexandro; Ibarra, Guadalupe; Saúl, Amado; Paredes-Solis, Vanessa; Carrasco‐Gerard, Eugenio; Fierro‐Arias, Leonel

doi:10.1097/01.inf.0000247108.86199.64

Cited by 33 publications

(22 citation statements)

References 9 publications

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“…Some cases were reported in elderly, however we must consider that the infection may have started many years ago, suggesting that these individuals may have acquired the disease in youth. Moreover, only 4% of the cases were reported in patients <18 years old similar to previously reported studies [6], [30]. The percentage of children infected in our study (and other reports [6], [30]) differed from a report by Fahal et al [31] that described a 15% infection rate (n = 722) in children in Sudan, this was probably due to their outdoor work activities.…”

Section: Discussionsupporting

confidence: 72%

“…Moreover, only 4% of the cases were reported in patients <18 years old similar to previously reported studies [6], [30]. The percentage of children infected in our study (and other reports [6], [30]) differed from a report by Fahal et al [31] that described a 15% infection rate (n = 722) in children in Sudan, this was probably due to their outdoor work activities. However, the same study reported trauma in only 22.5% patients suggesting that different mechanisms of infection that deserve to be clarified [1], [31].…”

Section: Discussionsupporting

confidence: 72%

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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: Discussionsupporting

confidence: 72%

Section: Discussionsupporting

confidence: 72%

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

et al. 2014

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“…A hormonal cause could explain the greater susceptibility of men. This hypothesis is supported by the fact that eumycetoma growth is inhibited in the presence of progesterone [2,19,20], by the observation that in case of pregnancy mycetomas are more active [16], and that on the contrary in children they are less frequent and less aggressive [6,21].…”

Section: Clinical and Diagnostic Aspectsmentioning

confidence: 81%

Management of mycetomas in France

Mattioni

Develoux

Brun

et al. 2013

Médecine et Maladies Infectieuses

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“…In children the disease is uncommon and foot is commonly involved site. In a retrospective study spanning 25 years, out of 334 mycetomas, only 2 cases of eumycetoma were encountered in children of 15 years or younger (0.6), only 4.5% patients out of 334 [3] were in this age group and foot was affected in 66.6% of them. Both the eumycetomas in this study were caused by Madurella mycetomats.…”

Section: Discussionmentioning

confidence: 99%

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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Mycetoma in Children: Experience With 15 Cases

Abstract: Mycetomas are exceptional in children; in our setting, actinomycetomas are more frequent than eumycetomas. The clinical and microbiologic diagnosis is simple. Overall, treatment response is better for actinomycetomas than for eumycetomas.

Cited by 33 publications

References 9 publications

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

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

Management of mycetomas in France

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

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