Mycetoma

Mycetoma
SpecialtyInfectious diseases
SymptomsTriad: painless firm skin lump, multiple weeping sinuses, grainy discharge[1]
Usual onsetSlowly progressive[1]
Types
Diagnostic methodUltrasound, fine needle aspiration[1]

Mycetoma is a chronic infection in the skin caused by either bacteria (actinomycetoma) or fungi (eumycetoma), typically resulting in a triad of painless firm skin lumps, the formation of weeping sinuses, and a discharge that contains grains.[1] 80% occur in feet.[1]

Most eumycetoma is caused by M. mycetomatis, whereas most actinomycetoma is caused by N. brasiliensis, S. somaliensis, A. madurae and Actinomadura pelletieri.[1] People who develop mycetoma likely have a weakened immune system.[1] It can take between 3 months to 50 years from time of infection to first seeking healthcare advice.[1]

Diagnosis requires ultrasound and fine needle aspiration.[1]

While most cases of mycetoma occur in Sudan, Venezuela, Mexico, and India, its true prevalence and incidence are not well-known.[2][3] It appears most frequently in people living in rural areas, particularly in farmers and shepherds, who are often men between 20 and 40 years earning the primary incomes for their families.[1] It has been reported since 1840.[4] Noteworthy, the diagnosis of mycetoma in non-endemic or low endemic areas as Europe and North Africa is challenging.[5][6] Physicians in these areas are usually unfamiliar with the disease-specific manifestations and need to exercise extra vigilance regarding those patients who are at high risk of contracting mycetoma infections.[7] Recent evidence suggests that Egypt, which borders sub-Saharan Africa, is a low-endemic country.[5] Additionally, recent evidence suggests that Pakistan, which borders India, is a moderate-endemic country.[8] Unlike bacterial acute hematogenous osteomyelitis and septic arthritis, misdiagnosed or delayed diagnosis of mycetoma osteomyelitis can result in amputation or radical resection.[5] The disease is listed by the World Health Organization (WHO) as a neglected tropical disease.[3]

  1. ^ a b c d e f g h i j k l Zijlstra, Eduard E.; Sande, Wendy W. J. van de; Welsh, Oliverio; Mahgoub, El Sheikh; Goodfellow, Michael; Fahal, Ahmed H. (1 January 2016). "Mycetoma: a unique neglected tropical disease". The Lancet Infectious Diseases. 16 (1): 100–112. doi:10.1016/S1473-3099(15)00359-X. ISSN 1473-3099. PMID 26738840.
  2. ^ Welsh O, Al-Abdely HM, Salinas-Carmona MC, Fahal AH (October 2014). "Mycetoma medical therapy". PLOS Neglected Tropical Diseases. 8 (10): e3218. doi:10.1371/journal.pntd.0003218. PMC 4199551. PMID 25330342.
  3. ^ a b van de Sande WW, Maghoub El S, Fahal AH, Goodfellow M, Welsh O, Zijlstra E (March 2014). "The mycetoma knowledge gap: identification of research priorities". PLOS Neglected Tropical Diseases. 8 (3): e2667. doi:10.1371/journal.pntd.0002667. PMC 3967943. PMID 24675533.
  4. ^ Cite error: The named reference Sande2013 was invoked but never defined (see the help page).
  5. ^ a b c 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.
  6. ^ Buonfrate, D; Gobbi, F; Angheben, A; Marocco, S; Farina, C; Van Den Ende, J; Bisoffi, Z (2014). "Autochthonous cases of mycetoma in Europe: report of two cases and review of literature". PLOS ONE. 9 (6): e100590. Bibcode:2014PLoSO...9j0590B. doi:10.1371/journal.pone.0100590. PMC 4070928. PMID 24963778.
  7. ^ Barış, Ayşe; Öncül, Ahsen; Öztürk, Kahraman; Barış, Alican; Aykut, Serkan; Aktaş, Elif (19 April 2021). "Mikolojik Tanının Önemi: 20 Yıl İhmal Edilen Bir Scedosporium apiospermum Kompleks Miçetoma Olgusu". Mikrobiyoloji Bulteni. 55 (2): 256–264. doi:10.5578/mb.20219911. PMID 33882656. S2CID 241887330.
  8. ^ Zeeshan, Mohammad; Fatima, Saira; Farooqi, Joveria; Jabeen, Kauser; Ahmed, Arsalan; Haq, Afreen; Arif, Muhammad Omer; Zafar, Afia (29 July 2022). "Reporting of mycetoma cases from skin and soft tissue biopsies over a period of ten years: A single center report and literature review from Pakistan". PLOS Neglected Tropical Diseases. 16 (7): e0010607. doi:10.1371/journal.pntd.0010607. PMC 9365187. PMID 35905141.