Eumycetoma by Madurella mycetomatis with 30 years of evolution: therapeutic challenge

Sampaio, Felipe Maurício Soeiro; Galhardo, Maria Clara Gutierrez; Quintella, Leonardo Pereira; Souza, Paulo Roberto Cotrim de; Coelho, Janice Mary Chicarino de Oliveira; Valle, Antônio Carlos Francesconi do

doi:10.1590/abd1806-4841.20132136

Cited by 8 publications

(12 citation statements)

References 8 publications

(21 reference statements)

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“…It is a chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma) [1]. Indeed, a bacterial origin is found in 60%, whereas fungi are responsible of 40% of cases reported worldwide [2]. Moreover, causative bacterial agents are more numerous than fungal agents (only four agents reported) [9] ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Mycetoma is a chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma) [1]. It occurs typically in young men between 20 and 40 years old, and is the prerogative of farmers who are exposed to contaminated soil during minor injuries in most cases [2]. Clinically, mycetoma or « Madura foot » is an inflammatory tumor, often polyfistulised, evolving in a chronic mode.…”

Section: Introductionmentioning

confidence: 99%

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Madurella mycetomatis infection of the foot: a case report of a neglected tropical disease in a non-endemic region

et al. 2020

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Background: Mycetoma is an uncommon chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma). It is the prerogative of young men between the third and fourth decade and is transmitted through any trauma causing an inoculating point. The classic clinical triad associates a painless hard and swelling subcutaneous mass, multiple fistulas, and the pathognomonic discharge of grains. Although endemic in many tropical and subtropical countries, mycetoma can also be found in non-endemic areas as in Morocco, and causes then diagnosis problems leading to long lasting complications. Therefore, we should raise awareness of this neglected disease for an earlier management. Under medical treatment however, mycetoma has a slow healing and surgery is often needed, and relapses are possible. Case presentation: Herein we report a case of a 64 years old patient, with a history of eumycetoma occurring ten years ago treated with oral terbinafine coupled with surgery. A complete remission was seen after 2 years. He presented a relapse on the previous scar 6 months ago. There wasn't any bone involvement in the magnetic resonance imaging (MRI). The patient was put under oral terbinafine with a slow but positive outcome. Conclusion: Through this case report, we perform a literature review and highlight the importance of increase awareness of mycetoma in clinical practice especially in non-endemic regions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Madurella mycetomatis infection of the foot: a case report of a neglected tropical disease in a non-endemic region

et al. 2020

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“…The treatment dropouts were high and they were likely related to delayed clinical responses and the prolonged treatment times. Recurrence was also frequent [20] and prevailed in patients that had undergone surgery [21]. The reasons are unknown, but may be likely due to the existence of undiagnosed subclinical lesions fungal defence mechanisms against antifungal drugs or incomplete surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological profile and spectrum of neglected tropical disease eumycetoma from Delhi, North India

et al. 2019

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Mycetoma is a chronic granulomatous, suppurative and progressive inflammatory disease that usually involves the subcutaneous tissue and bones after traumatic inoculation of the causative organism. In India, actinomycotic mycetoma is prevalent in south India, south-east Rajasthan and Chandigarh, while eumycetoma, which constitutes one third of the total cases, is mainly reported from north India and central Rajasthan. The objective was to determine the epidemiological profile and spectrum of eumycetoma from a tertiary care hospital in Delhi, North India. Thirty cases of eumycetoma were diagnosed by conventional methods of direct microscopy, culture and species-specific sequencing as per standard protocol. The spectrum of fungal pathogens included Exophiala jeanselmei, Madurella mycetomatis, Fusarium solani, Sarocladium kiliense, Acremonium blochii, Aspergillus nidulans, Fusarium incarnatum, Scedosporium apiospermum complex, Curvularia lunata and Medicopsis romeroi. Eumycetoma can be treated with antifungal therapy and needs to be combined with surgery. It has good prognosis if it is timely diagnosed and the correct species identified by culture for targeted therapy of these patients. Black moulds required prolonged therapy. Its low reporting and lack of familiarity may predispose patients to misdiagnosis and consequently delayed treatment. Hence health education and awareness campaign on the national and international level in the mycetoma belt is crucial.

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“…The infection can be caused by a variety of bacteria (actinomycetoma) and fungi (eumycetoma). In more than 80% of all cases, the foot and legs are affected [1, 2]. Eumycetoma of the hand, buttocks, or thorax is unusual, as seen in the case we describe.…”

Section: Introductionmentioning

confidence: 54%

“…Mycetoma is endemic in many countries in the tropics and subtropics, although most cases are reported from Sudan, Mexico, and India [4]. It occurs typically in young men between the age of 20 and 40 years, especially farmers who are exposed to contaminated soil, and is transmitted during one or more generally minor injuries [1].…”

Section: Introductionmentioning

confidence: 99%

Madurella mycetomatis infection of the buttock in an Eritrean refugee in Switzerland: a case report

2019

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BackgroundMycetoma is a neglected infectious disease caused by a fungus (eumycetoma) or bacteria (actinomycetoma); it is characterized by chronic local inflammation with sinus formation and purulent discharge. Its course can be quite devastating because of the difficulty in diagnosing the infection and in eliminating the causative agent. Although endemic in many countries in the tropics and subtropics, the migration of Africans to Europe may increase the presence of this neglected disease in European countries. We present a case of an Eritrean patient living in a non-endemic country who was diagnosed as having an infection of Madurella mycetomatis in an atypical location in his body.Case presentationWe report the case of a 35-year-old African male refugee from Eritrea, living in Switzerland since 2015, who presented with a 1-year history of a painful soft tissue swelling associated with dark nodules in his right buttock. He mentioned having several previous surgeries after 2001 while he was in Eritrea due to recurrent abscess formation on this body area. In the previous months, the swelling had become more significant and nodules started draining a purulent fluid. An initial diagnostic hypothesis of buttock abscess was made and he was referred to a dermatologist for diagnostic confirmation and further specialist care due to the size and atypical presentation. After a punch biopsy, the diagnosis of eumycetoma was confirmed and cultures developed Madurella mycetomatis. The initial treatment approach consisted of oral treatment by itraconazole; however, a surgical resection of the lesions was finally needed.ConclusionsAlthough rare, mycetoma should be diagnosed as early as possible to avoid long-lasting complications. Primary care physicians in European countries are frequently in the first line of care of migrant patients and therefore should be aware of the common and uncommon clinical presentations of mycetoma.

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Eumycetoma by Madurella mycetomatis with 30 years of evolution: therapeutic challenge

Cited by 8 publications

References 8 publications

Madurella mycetomatis infection of the foot: a case report of a neglected tropical disease in a non-endemic region

Madurella mycetomatis infection of the foot: a case report of a neglected tropical disease in a non-endemic region

Epidemiological profile and spectrum of neglected tropical disease eumycetoma from Delhi, North India

Madurella mycetomatis infection of the buttock in an Eritrean refugee in Switzerland: a case report

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