Recurrent eumycetoma caused by novel species Madurella pseudomycetomatis: A case report

Abstract

Mycetoma is a chronic-granulomatous disease characterized by the inflammation, swollen organ, draining sinuses containing blood, pus, and grains. We present a case of madura foot with novel etiologic agent Madurella pseudomycetomatis. Diagnosis was based on morphologic, physiologic, histipathologic and molecular methods. In vitro antifungal susceptibility tests revealed that MIC values for itraconazole, amphotericin B, and posaconazole were 0.0313 μg/ml, 0.0313 μg/ml, and 0.004 μg/ml, respectively. The patient was treated and recovered by itraconazole(400 mg/day) after prolonged course.

Phaehyphomycosis or Eumycetoma: A Case Report of a Diagnostic Dilemma

“…Sometimes the lesions may coalesce and form a single large cavity, which later surrounded by a capsule and thus giving a cyst like appearance. Classical triad of painless subcutaneous mass, sinuses, and a discharge containing granules is pathognomonic for Madura foot or mycetoma (2). Atypical mycetoma presentations may have absence of sinuses and granules (5).…”

“…HPE may highlight the presence of fungal bodies by using special stains like PAS and GMS. In eumycotic mycetoma, histology of tissue showed multiple micro abscessess with intradermal mycetoma consist of a necrotic core where palisading histiocytes and eosinophilic hyaline material surrounded the fungal colonies referred as "Splendore-Hoeppli" reaction (2)(3)(4). Focal giant cell reaction with reactive fibrosis and chronic inflammatory response surrounding the micro abscess may also be seen in the outermost layer.…”

“…They are sometimes indistinguishable from a condition called mycetoma also known as "Madura foot". Mycetoma is a localized chronic, suppurative infection affecting skin, subcutaneous tissue, and bones caused by either bacteria (actinomycetomas) or fungi (eumycetomas) (2). Dematiaceous fungi are heterogeneous group of melanized fungi found ubiquitously in the environment (1).…”

Eumycetoma Caused by Madurella pseudomycetomatis in a Captive Tiger (Panthera tigris)

“…Based on the availability of formalin-fixed paraffin-embedded block (FFPE) material, sections were submitted for a DNA-based molecular approach, which led to the identification of Madurella pseudomycetomatis as the causative agent. To date, only rare cases of M. pseudomycetomatis infection in the human literature have been reported; it is considered a neglected disease, endemic in tropical and subtropical countries [24][25][26]. In veterinary medicine, only a recent report by Albanese et al (2022) in a dog described a subcutaneous mass on the inner thigh [27].…”