Analyse d’une série tunisienne de 18 cas de mycétomes à l’hôpital de Sousse (1974–2010)

Aounallah, A.; Boussofara, L.; Said, Z. Ben; Ghariani, Najet; Saïdi, W.; Denguezli, M.; Belajouza, C.; Nouira, R.

doi:10.1007/s13149-012-0233-1

Cited by 10 publications

(6 citation statements)

References 3 publications

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“…Extra pedal mycetoma was encountered in the studied population but less frequent, which is again in agreement with other reports [ 41 – 44 ]. It is interesting to note, in the different sites, eumycetoma was the commonest type which contradicts some other reports which showed most of the extra-pedal mycetoma are actinomycetoma [ 34 , 35 ].…”

Section: Discussionsupporting

confidence: 93%

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Mycetoma in the Sudan: An Update from the Mycetoma Research Centre, University of Khartoum, Sudan

et al. 2015

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This communication reports on the Mycetoma Research Centre of the University of Khartoum, Sudan experience on 6,792 patients seen during the period 1991–2014.The patients were predominately young (64% under 30 years old) males (76%). The majority (68%) were from the Sudan mycetoma belt and 28% were students. Madurella mycetomatis eumycetoma was the most common type (70%). In 66% of the patients the duration of the disease was less than five years, and 81% gave a history of sinuses discharging mostly black grains (78%). History of trauma at the mycetoma site was reported in 20%. Local pain was reported in 27% of the patients, and only 12% had a family history of mycetoma. The study showed that 57% of the patients had previous surgical excisions and recurrence, and only 4% received previous medical treatment for mycetoma. Other concomitant medical diseases were reported in 4% of the patients. The foot (76%) and hand (8%) were the most commonly affected sites. Less frequently affected sites were the leg and knee (7%), thigh (2%), buttock (2%) and arm and forearm (1%). Rare sites included the chest wall, head and neck, back, abdominal wall, perineum, oral cavity, tongue and eye. Multiple sites mycetoma was recorded in 135 (2%) of cases. At presentation, 37% of patients had massive lesions, 79% had sinuses, 8% had local hyper-hydrosis at the mycetoma lesion, 11% had regional lymphadenopathy, while 6% had dilated tortuous veins proximal to the mycetoma lesions. The diagnosis of mycetoma was established by combined imaging techniques and cytological, histopathological, serological tests and grain culture. Patients with actinomycetoma received a combination of antimicrobial agents, while eumycetoma patients received antifungal agents combined with various surgical excisions. Surgical excisions in the form of wide local excision, debridement or amputation were done in 807 patients, and of them 248 patients (30.7%) had postoperative recurrence. Different types of amputations were done in 120 patients (1.7%).

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Section: Discussionsupporting

confidence: 93%

“…Rare mycetoma sites in this study included the eye, scrotum, oral cavity, palate and tongue. This has been observed by others [ 41 – 44 ].…”

Section: Discussionsupporting

confidence: 85%

Mycetoma in the Sudan: An Update from the Mycetoma Research Centre, University of Khartoum, Sudan

et al. 2015

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“…Mycetoma can produce many distortions, deformities and disabilities and that is due to structural impairment that includes bone destruction or periostitis, loss of function and disuse atrophy of the affected limb. The current treatment options are limited and suboptimal; many patients undergo repeated massive surgical excisions leading to more tissue destruction and fibrosis and disability ( Figure 8 ) [ 38 ].…”

Section: The Clinical Presentationmentioning

confidence: 99%

Mycetoma: The Spectrum of Clinical Presentation

Fahal

Suliman

Hay³

2018

TropicalMed

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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.

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“…Clinically, mycetoma starts as a small painless subcutaneous mass that gradually increases in size, then multiple sinuses with seropurulent discharge that contained grains of different colour and sizes develop [ 23 , 24 , 25 , 26 ]. Most patients present late with advanced disease and serious complications due to the painless nature of the disease, patients’ low health education level and lack of health facilities in endemic areas [ 27 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

A holistic approach to the mycetoma management

et al. 2018

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Mycetoma, one of the badly neglected tropical diseases, it is a localised chronic granulomatous inflammatory disease characterised by painless subcutaneous mass and formation of multiple sinuses that produce purulent discharge and grains. If untreated early and appropriately, it usually spread to affect the deep structures and bone resulting in massive damage, deformities and disabilities. It can also spread via the lymphatics and blood leading to distant secondary satellites associated with high morbidity and mortality. To date and despite progress in mycetoma research, a huge knowledge gap remains in mycetoma pathogenesis and epidemiology resulting in the lack of objective and effective control programmes. Currently, the available disease control method is early case detection and proper management. However, the majority of patients present late with immense disease and for many of them, heroic substantial deforming surgical excisions or amputation are the only prevailing treatment options. In this communication, the Mycetoma Research Center (MRC), Sudan shares its experience in implementing a new holistic approach to manage mycetoma patients locally at the village level. The MRC in collaboration with Sennar State Ministry of Health, Sudan had established a region mycetoma centre in one of the endemic mycetoma villages in the state. The patients were treated locally in that centre, the local medical and health personals were trained on early case detection and management, the local community was trained on mycetoma advocacy, and environmental conditions improvement. This comprehensive approach had also addressed the patients’ socioeconomic constraints that hinder early presentation and treatment. This approach has also included the active local health authorities, community and civil society participation and contributions to deliver the best management. This holistic approach for mycetoma patients’ management proved to be effective for early case detection and management, optimal treatment and treatment outcome and favourable disease prognosis. During the study period, the number of patients with massive lesions and the amputation rate had dropped and that had reduced the disease medical and socioeconomic burdens on patients and families.

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Analyse d’une série tunisienne de 18 cas de mycétomes à l’hôpital de Sousse (1974–2010)

Cited by 10 publications

References 3 publications

Mycetoma in the Sudan: An Update from the Mycetoma Research Centre, University of Khartoum, Sudan

Mycetoma in the Sudan: An Update from the Mycetoma Research Centre, University of Khartoum, Sudan

Mycetoma: The Spectrum of Clinical Presentation

A holistic approach to the mycetoma management

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