The Accuracy of Histopathological and Cytopathological Techniques in the Identification of the Mycetoma Causative Agents

Siddig, Emmanuel Edwar; Mhmoud, Najwa Adam; Bakhiet, Sahar Mubarak; Abdallah, Omnia Babekir; Mekki, Salwa O.; Dawi, N. I. El; Sande, Wendy W. J. van de; Fahal, Ahmed H.

doi:10.1371/journal.pntd.0007056

Cited by 44 publications

(70 citation statements)

References 35 publications

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“… 1–3 It is a chronic infectious disease that leads to destructive granulomatous inflammation, eventually causing deformity to the affected body part limb, impeding mobility. 4 , 5 Mycetoma is reported worldwide, but it is endemic in tropical and subtropical regions. 6 , 7 Mycetoma-endemic areas are characterised by moderate aridity, low humidity and a short rainy season.…”

Section: Introductionmentioning

confidence: 99%

Modelling the spatial distribution of mycetoma in Sudan

Hassan

Simpson

Cano

et al. 2021

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Mycetoma is a neglected tropical disease that is reported worldwide and Sudan has the highest reported number of mycetoma infections across the globe. The incidence, prevalence and burden of mycetoma globally are not precisely known and its risk factors remain largely unelucidated. Methods This study aimed to identify the environmental predictors of fungal and bacterial mycetoma in Sudan and to identify areas of the country where these niche predictors are met. Demographic and clinical data from confirmed mycetoma patients seen at the Mycetoma Research Centre from 1991 to 2018 were included in this study. Regression and machine learning techniques were used to model the relationships between mycetoma occurrence in Sudan and environmental predictors. Results The strongest predictors of mycetoma occurrence were aridity, proximity to water, low soil calcium and sodium concentrations and the distribution of various species of thorny trees. The models predicted the occurrence of eumycetoma and actinomycetoma in the central and southeastern states of Sudan and along the Nile river valley and its tributaries. Conclusion Our results showed that the risk of mycetoma in Sudan varies geographically and is linked to identifiable environmental risk factors. Suitability maps are intended to guide health authorities, academic institutes and organisations involved in planning national scale surveys for early case detection and management, leading to better patient treatment, prevention and control of mycetoma.

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Section: Introductionmentioning

confidence: 99%

Modelling the spatial distribution of mycetoma in Sudan

Hassan

Simpson

Cano

et al. 2021

Transactions of the Royal Society of Tropical Medicine and Hygiene

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“…A. madurae grains are large, basophilic, not uniformly stained, with a pale center and eosinophilic fringe. [ 1 13 ]…”

Section: Discussionmentioning

confidence: 99%

Actinomycetoma by Actinomadura madurae

Bonifáz

Tirado‐Sánchez

Vázquez-González

et al. 2021

Indian Dermatology Online Journal

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Context: Mycetoma is a chronic, granulomatous disease caused by fungi (eumycetoma) or aerobic filamentous actinomycetes (actinomycetoma). Actinomadura madurae is one of the most frequent actinomycetes. Aim: The study aims to provide an update on clinical, diagnostic, therapeutic, and outcome data for patients with actinomycetoma in a single center in Mexico. Settings and Design: This was a retrospective study of 47 cases diagnosed with actinomycetoma. Subjects and Methods: The cases were selected from a total of 536 mycetoma obtained during 35 years (from 1985 to 2019). Clinical data were retrieved from the clinical records of our department. Microbiological data were obtained from our Mycology laboratory. Statistical Analysis: Frequencies and percentages were used for categorical variables. Normality was determined with the Kolmogorov–Smirnov test. We used means and medians to describe the variables. Results: Forty-seven patients with actinomycetoma were included; female:male ratio 1.9:1; median age 38 years. The foot was the most affected region in 76.5% of cases. The bone invasion was observed in 89%. The time between symptoms onset and diagnosis was 5.5 years. Grain detection by direct examination was positive in 95% of cases. The most commonly used, as well as the most effective treatment scheme was streptomycin + sulfamethoxazole-trimethoprim with dapsone. Sixty-three percent (30 patients) achieved clinical and mycological cure, and 10.6% (5 patients) had treatment failure. Conclusions: We highlight the importance of designing therapeutic strategies to standardize treatments and gain more experience to improve the care of these patients.

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“…Diagnosis of the mycetoma and identification of etiological agents is a challenging issue, especially in non-endemic areas. Microbiological culture and histopathological analysis are the diagnostic tools used for the identification of causal agent(s) [ 7 ] but they possess some drawbacks, including failure in culture, difficulties in the direct examination or invasive biopsy [ 25 ]. Molecular analysis of bacterial species isolated from our patient revealed A. madurae as the etiologic agent with ≥99% identity with GenBank sequences.…”

Section: Discussionmentioning

confidence: 99%

Molecular identification of Actinomadura madurae isolated from a patient originally from Algeria; observations from a case report

et al. 2020

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Background Mycetoma is a chronic granulomatous subcutaneous infection caused by anaerobic pseudofilamentous bacteria or fungi. It is commonly prevalent in tropical and subtropical countries. Men are more susceptible to the disease due to greater participation in agricultural works. Mycetoma commonly involves lower extremities, wherein untreated cases lead to aggressive therapeutic choices, such as amputation of the affected body organs and consequently lifelong disability. Case presentation In this report, we present the rare case of a 58-year-old man, originally from Algeria with a left foot chronic tumefaction of 5 years. In the initial clinical examination, mycetoma was diagnosed based on tumefaction and the presence of multiple sinuses with the emission of white grains. The latter was observed via direct examination. The histopathological analysis demonstrated an actinomycetoma caused by bacteria, as the etiological agent. Imaging showed a bone involvement with osteolysis at the levels of 2nd to 4th metatarsal diaphysis. The mycological and bacterial cultures were both negative. For an accurate diagnosis, the obtained grains were subjected to molecular analysis, targeting the 16S-rDNA gene. Molecular identification yielded Actinomadura madurae as the causal agent, and 800/160 mg of trimethoprim/sulfamethoxazole was prescribed twice a day for 1 year, as a treatment. Conclusion Considering low information about this disease, especially in non-endemic areas, it is of high importance to enhance the knowledge and awareness of clinicians and healthcare providers, in particular in the countries with immigration issues.

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The Accuracy of Histopathological and Cytopathological Techniques in the Identification of the Mycetoma Causative Agents

Cited by 44 publications

References 35 publications

Modelling the spatial distribution of mycetoma in Sudan

Modelling the spatial distribution of mycetoma in Sudan

Actinomycetoma by Actinomadura madurae

Molecular identification of Actinomadura madurae isolated from a patient originally from Algeria; observations from a case report

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