Mycetoma (Madura Foot) in Israel: Recent Cases and a Systematic Review of the Literature

Abstract

Mycetoma is a chronic soft tissue infection caused by fungal or bacterial pathogens, and is endemic in tropical and subtropical regions. Cases in developed countries outside the mycetoma belt are rare and usually imported by immigrants. Sporadic cases have been reported in Israel. Unpublished cases in the participating medical centers are reported. In addition, a systematic review of the literature was performed. All published mycetoma cases diagnosed in Israel were included with relevant variables collected. Twenty-one cases of mycetoma were diagnosed in Israel between 1942 and 2015, including four unpublished cases and 17 published cases. The mean age at diagnosis was 42 years (range 23-73), and 16 of the patients were male. The foot was the primary involved organ. Fifteen patients were immigrants from Yemen, Ethiopia, and Sudan. Five cases were autochthonous. One case was travel related. Among patients who developed symptoms after immigration, the mean time from exposure to symptom onset was 5.6 years (range 1-10 years). The mean time from symptom onset to diagnosis was 6.6 years (range 0.2-35 years). The autochthonous cases demonstrate that Israel is endemic of mycetoma. The immigrant population represents two distinct waves of immigration to Israel in the past century. Two unpublished cases of Ethiopian immigrants are the first reported cases of mycetoma acquired in Ethiopia. The diagnostic and therapeutic challenges along with the epidemiological data emphasize the need of raising the awareness of physicians to this devastating condition even in developed countries.

Climate, soil type, and geographic distribution of actinomycetoma cases in Northeast Mexico: A cross-sectional study

“…As previously mentioned, thorn and splinter prick wounds of different species have been associated with mycetoma suggesting a relationship between the casual agents and the plants [2]. Patients with mycetoma often work in agropastoral areas walking barefooted or using sandals, being susceptible to a traumatic lesion with thorn or splinters [3,13,14]. Even though in Mexico is common that people in rural areas wear sandals, all our patients wore boots and shoes.…”

Immunoinformatics Prediction of Epitope Based Peptide Vaccine AgainstMadurella mycetomatis Translationally Controlled Tumor Protein

“…. It is distributed worldwide, but it is endemic in tropical and subtropical regions (6)(7)(8).These region sknown as the "Mycetoma belt" including (Sudan, Somalia, Yemen, Senegal, India, Mexico, Venezuela, Colombia and Argentina) while the most reported cases were from Sudan and Mexico, Sudan being the most endemic country (9) (10,11). Mycetoma can be found in areas geographically close proximity to Tropic of Cancer (1).…”

Painless Progressive Swelling of the Foot with Discharging Sinuses (Madura Foot)

“…The term Madura foot or Mycetoma pedis is used to describe chronic granulomatous disease caused by true fungi (eumycetoma) or filamentous bacteria (actinomycetoma). 1 , 2 Both agents produce similar lesions and are characterized by the classic triad of a subcutaneous mass, sinus tract formation, and granular discharge. However, actinomycetoma is more aggressive and destructive and invades bone earlier than eumycetoma.…”

“…Whereas eumycetoma may require surgical debridement in addition to antifungal therapy, most of actinomycetomas are successfully treated with antibiotics. 2 …”