The “dot-in-circle” sign — a characteristic MRI finding in mycetoma foot: a report of three cases

Cherian, R.; Betty, M.; Manipadam, M.T.; Cherian, Vinoo Mathew; Poonnoose, Pradeep Mathew; Oommen, Anil Thomas; Cherian, Rekha

doi:10.1259/bjr/62386689

Cited by 41 publications

(41 citation statements)

References 4 publications

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“…The "dot-incircle" sign has been noted to be specific for the finding of eumycetoma in magnetic resonance imaging (MRI) studies (141). This is felt to be due to the low signal intensity produced by the fungal grains in tissue.…”

Section: Radiologymentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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SUMMARY Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.

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Section: Radiologymentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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“…The ‘dot-in-circle sign’ is highly specific for mycetoma. This is the appearance of fungal grains as low signal intensity within hyper-intense lesions representing the surrounding granulomata 10 11. Furthermore, a radiological scoring system has been developed in Sudan, called the ‘Mycetoma Skin, Muscle, Bone Grading System’ (MSMBS).…”

Section: Discussionmentioning

confidence: 99%

An unusual cause of an ankle mass

et al. 2014

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We report the case of a patient who presented with a 7-year history of a mass over the medial aspect of his right ankle, which had been gradually increasing in size. He had given up his occupation as a bus driver due to decreased movement of his ankle. An initial diagnosis of endemic syphilis was made after treponemal antibody and treponema pallidum particle agglutination tests were positive. However, following surgical debulking, cultures grew Fusarium solani and the diagnosis was changed to eumycetoma. He received prolonged treatment with antifungal agents and at 18 months follow-up remains well.

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“…4) that is highly suggestive of mycetoma. [5] Management of maduromycosis is based on the extent of the disease as assessed radiologically and on the causative agent as defined histologically. Actinomycetoma is amenable to medical treatment by antibiotics and antimicrobial agent combinations, while combined medical and surgical treatment is the gold standard in eumycetoma.…”

Section: Discussionmentioning

confidence: 99%