Cystic mycetoma: an unusual clinical presentation of Madurella mycetomatis infection

Atypical presentation of Madurella mycetomatis mycetoma in a renal transplant patient

“…Even after positive microscopy for fungal elements, mycetoma was not suspected because of the absence of granules in the pus. In a previous study from Sudan this presentation was described for the first time in four patients and was classified as cystic mycetoma ( 3). The major differences with our case were that all lesions were present on the chest wall, upper limbs, and supraclavicular and deltoid regions of the body, and classical mycetoma lesions with sinuses were in close proximity.…”

Tropical dermatology: Fungal tropical diseases

“…114,115,118,119 However, the disease has also been found in persons who work in the city in various occupations, in victims of road accidents who have incurred a traumatic inoculation of the agent, 126 and in travelers to tropical endemic areas. 127 Several pathogens are associated with eumycetomas in different parts of the world, the main ones being Acremonium sp and Madurella grisea in Brazil, 119 Madurella mycetomatis in India and Africa, 122,128 and Pseudallescheria boydii in North America. 114,129 Actinomycetomas are caused either by endogenous anaerobic bacteria such as Actinomyces israellii and Actinomyces bovis 130 or by aerobic bacteria (Actinomadura sp, Nocardia brasiliensis, and Streptomyces sp).…”

“…136 Actinomadura sp usually leads to massive bone destruction, while Madurella sp only causes a focal and restricted bone lesion. 128 HIV patients can present with destructive patterns of clinical lesions and pulmonary dissemination with chronic osteomyelitis and severe disability. 137,138 Fahal et al suggested that mycetomas produce substances that have an anesthetic action, because even the larger lesions are usually painless.…”

“…In the early stages, there is a soft-tissue granuloma, which presents as a dense shadow or as scattered multiple soft-tissue shadows. 128,136 Calcification and obliteration of the fascial planes may be present. As the disease progresses, the bone cortex can be compressed by the granuloma to form multiple punchedout cavities through the normal density of the bone.…”

Gallbladder Carcinoma and Its Mimics

“…In eumycetoma the lesion grows slowly and remains encapsulated for a long period, whereas in actinomycetoma the lesion is more inflammatory and destructive. Mycetoma may present as cystic lesion [17] . Review of literature showed cases of actinomycetoma of gallbladder but so far no case of eumycetoma of gallbladder has been reported in English literature [18][19][20][21] .…”