Mycetoma

Lewall, David B.; Ofole, S.; Bendl, Bernard J.

doi:10.1007/bf00352615

Cited by 31 publications

(30 citation statements)

References 5 publications

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“…Patients present with painless subcutaneous nodules and fistulae, from which a purulent exudate may be discharged. The process is usually indolent but with a potential for abscess formation, draining sinus tracts, osteomyelitis, and fistula formation,[14] with severe deformity and disability ensuing if treatment is not provided. Although antifungal medication is successful in almost 90% of cases, lesions not arising in the foot or due to fungus tend to have a worse prognosis and require surgery.…”

Section: Discussionmentioning

confidence: 99%

Case report: Dot-in-circle sign - An MRI and USG sign for "Madura foot"

Anitha¹,

Pillay

2011

Indian Journal of Radiology and Imaging

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Mycetoma is a chronic granulomatous disease that is more common in tropical than in temperate regions. Early diagnosis is important due to the therapeutic implications. Although biopsy and microbiological culture provide definitive diagnosis, they are time-consuming procedures and may not be able to provide a definite diagnosis in cases of fastidious organisms. The “dot-in-circle” sign has recently been proposed as a highly specific magnetic resonance imaging (MRI) and ultrasonography (USG) sign of mycetoma, which may allow a noninvasive as well as early diagnosis. We present a case of histologically proven mycetoma that demonstrated this sign.

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Section: Discussionmentioning

confidence: 99%

Case report: Dot-in-circle sign - An MRI and USG sign for "Madura foot"

Anitha¹,

Pillay

2011

Indian Journal of Radiology and Imaging

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“…This therapy could have aggravated a silent chronic infection in the soft tissue of the leg, a mycetoma by Nocardia asteroides. In the literature, the average duration of the symptoms in mycetomas has been calculated as 8 years (8). However, in our case, lesions in the lungs and in the brain were revealed in the relatively short time period after the symptoms of mycetoma appeared.…”

mentioning

confidence: 53%

“…Nocardia asteroides may cause mycetomas. Mycetoma is a chronic granulomatous process resulting from the implantation of one of various fungi or actinomycetes into soft tissues, usually of the foot (8,11). The disease is almost painless, and there are few or no constitutional symptoms unless there is a secondary bacterial infection (8).…”

mentioning

confidence: 99%

Nocardial Cerebral Abscess Associated with Mycetoma, Pneumonia, and Membranoproliferative Glomerulonephritis

Elmacı¹,

Senday²,

Sılav³

et al. 2007

J Clin Microbiol

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Nocardial brain abscesses remain a clinical challenge. We successfully treated a patient with nocardial brain abscess, mycetoma, pneumonia, and glomerulonephritis. Nocardial soft tissue involvement, mycetoma, is well known. However, the fact that actinomycetoma can metastasize may not be as well appreciated. The association between nocardiosis and glomerulonephritis should be better clarified. CASE REPORTA 49-year-old male, a businessman, was admitted to our hospital with complaints of severe edema of the lower extremities. Clinically, the diagnosis was nephrotic syndrome. Light microscopy of a renal biopsy showed fibrosis with mesangial hypercellularity and tubular atrophy. Immunofluorescence staining revealed deposition of immunoglobulin G and C 3 at the glomeruli, basal membranes, and mesangia. The diagnosis of a membranoproliferative glomerulonephritis was established, and the patient received oral treatment with prednisolone at 60 mg/kg per day. Because of persistent proteinuria, he underwent monthly intravenous pulse cyclophosphamide therapy. When the patient was hospitalized for his third course of cyclophosphamide therapy 9 months later, he was febrile, and physical examination revealed a tender mass in the anterolateral region of the left thigh. Laboratory findings revealed the following: white blood cell count, 13,360/mm 3 (normal range, 4 ϫ 10 9 to 10 ϫ 10 9 /liter); hemoglobin, 10.4 g/dl (normal range, 11 to 16 g/dl); hematocrit, 32.1% (normal range, 37 to 50%); erythrocyte sedimentation rate, 63 mm/h (normal range, Ͻ25 mm/h); cyclic AMP receptor protein, 16.2 mg/dl (normal range, Ͻ0.8 mg/dl); urea, 35 mg/dl (normal range, 10 to 50 mg/dl); creatinine, 0.8 mg/dl (normal range, 0.7 to 1.2 mg/dl); aspartate aminotransferase, 68 U/liter (normal range, 14 to 36 U/liter); and alanine aminotransferase, 116/liter (normal range, 9 to 52 U/liter). There was 5 g/day of proteinuria. Magnetic resonance imaging of the left lower extremity showed a mass lesion within the vastus lateralis muscle (Fig. 1). The mass had cystic characteristics and was multiloculated. The microbiological diagnosis was made from the aspirated pus of the mass lesion in the left lower extremity. The specimens, cultured on sheep blood agar, brain-heart infusion agar, and Sabouraud dextrose agar plates, were incubated at 37°C in the presence of 10% CO 2 plus air. Direct microscopic examination of aspirated Gram-stained pus showed gram-positive cocci, gram-positive filamentous branching bacilli, and polymorphonuclear neutrophils. The smear was stained with modified acid fast. After a 24-h incubation, typical smooth, yellow-pigmented, hemolyzed colonies were tested with the catalase, oxidase, coagulase, and ID 32 Staph tests (bioMérieux, Nutingen, Germany) and oxacillin on Mueller-Hinton agar. Methicillin-sensitive Staphylococcus aureus was identified. After 3 days of incubation, typical dry, chalky, dull, tough colonies appeared on the media. All species were gram-positive branching bacilli. These bacilli were identified as Nocardia species. ...

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“…It is important to detect if bone is infected as nonsurgical cure is uncertain in such cases [6]. Several different radiological signs should be sought.…”

Section: Imaging Technologymentioning

confidence: 99%

“…It is evident from this table that with classic radiology, multiple radiological changes can be detected. This method can be used to show the presence and extent of soft tissue granulomas [6] and to demonstrate bone invasion by the causative agent or the occurrence of pathological fractures [8]. Fractures, however, are uncommon; of the 517 patients seen in a diagnostic centre in Sudan, only 12 patients (2.3%) had pathological fractures [9]; no correlation was found between bone involvement and the duration of symptoms [6].…”

Section: Imaging Technologymentioning

confidence: 99%

Merits and Pitfalls of Currently Used Diagnostic Tools in Mycetoma

et al. 2014

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Treatment of mycetoma depends on the causative organism and since many organisms, both actinomycetes (actinomycetoma) and fungi (eumycetoma), are capable of producing mycetoma, an accurate diagnosis is crucial. Currently, multiple diagnostic tools are used to determine the extent of infections and to identify the causative agents of mycetoma. These include various imaging, cytological, histopathological, serological, and culture techniques; phenotypic characterisation; and molecular diagnostics. In this review, we summarize these techniques and identify their merits and pitfalls in the identification of the causative agents of mycetoma and the extent of the disease. We also emphasize the fact that there is no ideal diagnostic tool available to identify the causative agents and that future research should focus on the development of new and reliable diagnostic tools.

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Mycetoma

Cited by 31 publications

References 5 publications

Case report: Dot-in-circle sign - An MRI and USG sign for "Madura foot"

Case report: Dot-in-circle sign - An MRI and USG sign for "Madura foot"

Nocardial Cerebral Abscess Associated with Mycetoma, Pneumonia, and Membranoproliferative Glomerulonephritis

Merits and Pitfalls of Currently Used Diagnostic Tools in Mycetoma

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