Mycetoma: The Spectrum of Clinical Presentation

Abstract

Mycetoma is a chronic infection, newly designated by the World Health Organization (WHO) as a neglected tropical disease, which is endemic in tropical and subtropical regions. It follows implantation of infectious organisms, either fungi (eumycetomas) or filamentous bacteria (actinomycetomas) into subcutaneous tissue, from where infection spreads to involve skin, bone and subcutaneous sites, leading to both health related and socioeconomic problems. In common with other NTDs, mycetoma is most often seen in rural areas amongst the poorest of people who have less access to health care. The organisms form small microcolonies that are discharged onto the skin surface via sinus tracts, or that can burrow into other adjacent tissues including bone. This paper describes the clinical features of mycetoma, as early recognition is a key to early diagnosis and the institution of appropriate treatment including surgery. Because these lesions are mostly painless and the majority of infected individuals present late and with advanced disease, simplifying early recognition is an important public health goal.

Cystic form of Actinomycotic mycetoma: A new case with a diagnostic challenge

“…3,9 Clinical suspicion of mycetoma is based on the triad that includes progressive painless subcutaneous swelling, sinus tract formation, and granular discharge. 10 Our patient presented with a subcutaneous lump on the dorsum of his foot, not associated with sinuses or discharge as in more advanced cases.…”

“…Clinical suspicion of mycetoma is based on the triad that includes progressive painless subcutaneous swelling, sinus tract formation, and granular discharge 10 …”

One Health aspects & priority roadmap for fungal diseases

“…Improvement is slow and hard to evaluate, even after months of therapy. Many patients eventually fail to complete education or lose their jobs and become a burden on families and the community 65 .…”

The use of traditional medicines among mycetoma patients

“… 7 Less often, it affects the head and neck, chest and abdominal walls, as well as the perineal, inguinal and gluteal regions. 8 – 10 Most of the affected patients are young adults in the age group of 20–40 y and frequently they are farmers, students and labourers. 11 Out of 6792 confirmed mycetoma patients who presented to the Mycetoma Research Center (MRC) up to 2015, 5150 (76%) were males and 1642 (24%) were females and most (4353 [64%]) were aged <30 y at presentation.…”