Eumycetoma

For the bacterial disease formerly known as "actinomycetomabulus", see Actinomycosis.
Eumycetoma
Other namesMadura foot[1]
An infected foot
SpecialtyInfectious disease[2]
SymptomsSwelling, weeping pus filled sinuses, deformity.[3]
ComplicationsAmputation
CausesMadurella spp., Falciformispora senegalensis, Curvularia lunata, Pseudallescheria spp., Neotestudina spp., Acremonium spp., Scedosporium spp. and Fusarium spp. [2]
Diagnostic methodMicroscopy, biopsy, culture,[3] medical imaging, ELISA, immunodiffusion, DNA sequencing[4]
Differential diagnosisActinomycosis (Actinomycetoma)[3]
TreatmentSurgical debridement, antifungal medicines[3]
MedicationItraconazole, posaconazole, voriconazole[4]
PrognosisRecurrence is common[5]
FrequencyEndemic in Africa, India and South America[3]

Eumycetoma, also known as Madura foot,[1][6] is a persistent fungal infection of the skin and the tissues just under the skin, affecting most commonly the feet, although it can occur in hands and other body parts.[5] It starts as a painless wet nodule, which may be present for years before ulceration, swelling, grainy discharge and weeping from sinuses and fistulae, followed by bone deformity.[3]

Several fungi can cause eumycetoma,[5] including: Madurella mycetomatis, Madurella grisea, Curvularia lunata, Scedosporium species, Acremonium and Fusarium species.[2] Diagnosis is by biopsy, visualising the fungi under the microscope and culture.[5] Medical imaging may reveal extent of bone involvement.[4] Other tests include ELISA, immunodiffusion, and DNA Barcoding.[4]

Treatment includes surgical removal of affected tissue and antifungal medicines.[3] After treatment, recurrence is common.[5] Sometimes amputation is required.[5]

The infection occurs generally in the tropics,[7] and is endemic in Sub-Saharan Africa, especially Sudan, India, parts of South America and Mexico.[3] Few cases have been reported across North Africa.[8][9] Mycetoma is probably low-endemic to Egypt with predilection for eumycetoma.[10] In 2016, the World Health Organization recognised eumycetoma as a neglected tropical disease.[7]

  1. ^ a b Kutzner H, Kempf W, Feit J, Sangueza O (2021). "2. Fungal infections". Atlas of Clinical Dermatopathology: Infectious and Parasitic Dermatoses. Hoboken: Wiley Blackwell. pp. 77–108. ISBN 978-1-119-64706-5. Archived from the original on 10 June 2021. Retrieved 9 June 2021.
  2. ^ a b c "ICD-11 – ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Archived from the original on 1 August 2018. Retrieved 9 June 2021.
  3. ^ a b c d e f g h Johnstone RB (2017). "25. Mycoses and Algal infections". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 457. ISBN 978-0-7020-6830-0. Archived from the original on 25 May 2021. Retrieved 13 June 2021.
  4. ^ a b c d Cite error: The named reference Queiroz2017 was invoked but never defined (see the help page).
  5. ^ a b c d e f Estrada R, Chávez-López G, Estrada-Chávez G, López-Martínez R, Welsh O (July 2012). "Eumycetoma". Clinics in Dermatology. 30 (4): 389–396. doi:10.1016/j.clindermatol.2011.09.009. ISSN 1879-1131. PMID 22682186.
  6. ^ Barlow G, Irving I, moss PJ (2020). "20. Infectious diseases". In Feather A, Randall D, Waterhouse M (eds.). Kumar and Clark's Clinical Medicine (10th ed.). Elsevier. p. 561. ISBN 978-0-7020-7870-5. Archived from the original on 13 June 2021. Retrieved 13 June 2021.
  7. ^ a b Emery D, Denning DW (2020). "The global distribution of actinomycetoma and eumycetoma". PLOS Neglected Tropical Diseases. 14 (9): e0008397. doi:10.1371/journal.pntd.0008397. ISSN 1935-2735. PMC 7514014. PMID 32970667.
  8. ^ Elgallali N, El Euch D, Cheikhrouhou R, Belhadj S, Chelly I, Chaker E, Ben Osman A (June 2010). "[Mycetoma in Tunisia: a 15-case series]". Médecine Tropicale. 70 (3): 269–73. PMID 20734597.
  9. ^ Karrakchou B, Boubnane I, Senouci K, Hassam B (10 January 2020). "Madurella mycetomatis infection of the foot: a case report of a neglected tropical disease in a non-endemic region". BMC Dermatology. 20 (1): 1. doi:10.1186/s12895-019-0097-1. PMC 6953183. PMID 31918687.
  10. ^ Ahmed SA, El-Sobky TA, de Hoog S, Zaki SM, Taha M (9 September 2022). "A scoping review of mycetoma profile in Egypt: revisiting the global endemicity map". Transactions of the Royal Society of Tropical Medicine and Hygiene. 117 (1): 1–11. doi:10.1093/trstmh/trac085. PMC 9808524. PMID 36084235.