Nocardial mycetoma: Diverse clinical presentations

Sharma, Nand Lal; Mahajan, Vikram K.; Agarwal, Santwana; Katoch, Vishwa Mohan; Das, Ram; Kashyap, Meera; Gupta, Poonam; Verma, Ghanshyam

doi:10.4103/0378-6323.45110

Cited by 25 publications

(24 citation statements)

References 5 publications

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“…The majority of cases (62%) described in this report affected the foot, supporting previous reports [3], [5], [6], [10] and one meta-analysis [11] that described foot as the most common site of infection (68.7% of cases). Since mycetoma presented most often on the feet of individuals living in the Indian endemic region, it explains why initial reports mentioned it as “Madura foot” [11], [17], [18], [19]. Due to the predilection for feet, mycetoma control could be achieved by using appropriate footwear and clothing that protects the limbs.…”

Section: Discussionmentioning

confidence: 99%

Mycetoma: Experience of 482 Cases in a Single Center in Mexico

et al. 2014

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Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013). A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11%) were actinomycetomas and 38 cases (7.88%) were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3∶1. The mean age was 34.5 years old (most ranged from 21 to 40 years). The main affected localization was lower and upper limbs (70.74% and 14.52% respectively). Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported). The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%). Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21%) and Actinomadura madurae (8.7%); meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii) were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

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Section: Discussionmentioning

confidence: 99%

Mycetoma: Experience of 482 Cases in a Single Center in Mexico

et al. 2014

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“…must be differentiated from those produced by other actinomycetes and by those produced by fungus, and although the evolution of those caused by Nocardia is normally faster, they cannot be differentiated clinically [33].…”

Section: Clinical Featuresmentioning

confidence: 99%

Nocardiosis: Updated Clinical Review and Experience at a Tertiary Center

2010

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Nocardiosis is a rare opportunistic disease that affects mainly patients with deficient cell-mediated immunity, such as those with acquired immunodeficiency syndrome (AIDS) or transplant recipients. Pulmonary disease is the most common presentation in immunosuppressed patients and approximately one-third have a disseminated disease. Primary cutaneous nocardiosis is more frequently observed in immunocompetent patients with direct inoculation of the organism through professional exposure. The diagnosis can be challenging, as signs and symptoms are not specific and a high index of clinical of suspicion is necessary. Although gram stain, modified acid-fast stain, and cultures remain as the standard diagnostic tools, novel molecular techniques have changed the taxonomy of these organisms and, in some instances, have facilitated their identification. The disease has a marked tendency to recur and a high morbidity and mortality rate in immunosuppressed patients. Treatment is usually prolonged and an associated antibiotic treatment is preferred for severe disease. Although sulfonamides in combination with other antibiotics are still the treatment of choice, other associations such as imipenem plus amikacin are preferred in some centers. Linezolid is a useful alternative therapeutic agent due to its oral availability and activity against most of the isolates studied. Twenty-eight cases of nocardiosis were diagnosed at our center between January 1989 and April 2009. We report the epidemiologic characteristics of Nocardia spp. observed in our institution and discuss the risk factors, clinical features, diagnosis, and management of the disease.

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“…Eumycotic mycetomas were more common in northern India; however, the recent trend shows an increase in incidence of Actinomycetomas [5]. Besides mycetomas, clinical differential diagnosis in patients presenting with chronic discharging sinus in an extremity includes chromomycocysis, blastomycosis, coccidiomycosis, sporotrichosis, botryomycosis, syphillis, yaws and neoplasia [6]. Out of these, tuberculosis and mycetoma are the commonest.…”

Section: Resultsmentioning

confidence: 99%

An approach to histology-based diagnosis and treatment of Madura foot

Chufal

Thapliyal

Gupta

2012

J Infect Dev Ctries

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Madura foot is a deep mycosis commonly seen in tropical and subtropical countries such as India. Its incidence is likely to rise in temperate regions as well, due to the increase in worldwide travel. The cases presented here are all agricultural workers from a rural part of northern India who had induration, fibrosis and minimal discharge from sinuses over the foot. Although culture remains the gold standard diagnostic test, this case report highlights the importance of histopathology in the early diagnosis and differentiation of common causative agents in Madura foot as repeated cultures are sometimes negative. Thus for mycetomas in which causative infectious agents cannot be isolated, histology may prove beneficial by avoiding inadvertent use of combined antifungal and antimicrobial agents so that a correct therapeutic modality can be decided, prognostic outcome be explained to the patient, and a preventable cause of deformity and disability can be identified and treated at an early stage.

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Nocardial mycetoma: Diverse clinical presentations

Cited by 25 publications

References 5 publications

Mycetoma: Experience of 482 Cases in a Single Center in Mexico

Mycetoma: Experience of 482 Cases in a Single Center in Mexico

Nocardiosis: Updated Clinical Review and Experience at a Tertiary Center

An approach to histology-based diagnosis and treatment of Madura foot

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