Multiple Mycetoma Lung Secondaries from Knee Eumycetoma: An Unusual Complication

Mohamed, El Samani Wadaa; Din, Nancy Seif El; Fahal, Ahmed H.

doi:10.1371/journal.pntd.0004735

Cited by 10 publications

(10 citation statements)

References 8 publications

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“…Few blood-spread mycetoma cases [7,16,69,70,71,72] and deaths related to the infection were reported [4,9,70], but they were not observed in our study.…”

Section: Discussion and Review Of The Literaturecontrasting

confidence: 66%

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

et al. 2017

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Mycetoma is caused by the subcutaneous inoculation of filamentous fungi or aerobic filamentous bacteria that form grains in the tissue. The purpose of this study is to describe the epidemiologic, clinic, laboratory, and therapeutic characteristics of patients with mycetoma at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil, between 1991 and 2014. Twenty-one cases of mycetoma were included in the study. There was a predominance of male patients (1.3:1) and the average patient age was 46 years. The majority of the cases were from the Southeast region of Brazil and the feet were the most affected anatomical region (80.95%). Eumycetoma prevailed over actinomycetoma (61.9% and 38.1% respectively). Eumycetoma patients had positive cultures in 8 of 13 cases, with isolation of Scedosporium apiospermum species complex (n = 3), Madurella mycetomatis (n = 2) and Acremonium spp. (n = 1). Two cases presented sterile mycelium and five were negative. Six of 8 actinomycetoma cases had cultures that were identified as Nocardia spp. (n = 3), Nocardia brasiliensis (n = 2), and Nocardia asteroides (n = 1). Imaging tests were performed on all but one patients, and bone destruction was identified in 9 cases (42.68%). All eumycetoma cases were treated with itraconazole monotherapy or combined with fluconazole, terbinafine, or amphotericin B. Actinomycetoma cases were treated with sulfamethoxazole plus trimethoprim or combined with cycles of amikacin sulphate. Surgical procedures were performed in 9 (69.2%) eumycetoma and in 3 (37.5%) actinomycetoma cases, with one amputation case in each group. Clinical cure occurred in 11 cases (7 for eumycetoma and 4 for actinomycetoma), and recurrence was documented in 4 of 21 cases. No deaths were recorded during the study. Despite of the scarcity of mycetoma in our institution the cases presented reflect the wide clinical spectrum and difficulties to take care of this neglected disease.

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“…Few blood-spread mycetoma cases [7,16,69,70,71,72] and deaths related to the infection were reported [4,9,70], but they were not observed in our study.…”

Section: Discussion and Review Of The Literaturecontrasting

confidence: 66%

Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil

et al. 2017

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“…Although mycetoma is primarily a localised disease of gradual onset and slow progress, some patients present with massive, aggressive, uncontrolled disease and most of these are fatal. In these patients, the disease progressed wildly and aggressively from the subcutaneous tissue to involve the deep organs such as the urinary bladder, pelvic organs, spinal cord, lung and other structures and resulted in fatal outcome [ 53 , 54 , 55 , 56 ].…”

Section: Aggressive Mycetomamentioning

confidence: 99%

“…In these patients, Madurella mycetomatis had progressed widely without response to the different medical and surgical treatment modalities. Vascular spread, which is a rare phenomenon in mycetoma, may explain the secondary lung lesions encountered in these patients [ 52 , 54 , 55 , 56 ].…”

Section: Aggressive Mycetomamentioning

confidence: 99%

See 1 more Smart Citation

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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“…The chest wall is a rare site, accounting for 0.1% of 6,792 mycetoma patients seen at the MRC in the period 1991–2014 [ 4 , 5 ]. Only 2 patients with mycetoma-induced pulmonary complications were reported [ 6 , 7 ].…”

Section: Case Discussionmentioning

confidence: 99%