The global distribution of actinomycetoma and eumycetoma

Abstract

Background Mycetoma, a chronic infection of the skin and underlying structures, affects those with a close relationship to the land, often in resource-poor areas of the world. Whether caused by any one of a variety of fungus or bacteria, mycetoma causes significant disability and mortality. Acknowledged as a neglected tropical disease (NTD) by the World Health Organization (WHO) in 2016, mycetoma is susceptible to being misunderstood, misdiagnosed, and mismanaged. In an effort to shift the balance in favor of recognition and effective treatment, sound epidemiological understanding is required. Methods and findings In this paper, a literature review of case reports and series (332 papers in total) is presented as three maps. We identified 19,494 cases dating from 1876 to 2019, with cases contracted in 102 countries. The first map shows where mycetoma has ever been reported, the second shows how many cases have been reported, and the third shows the ratio of eumycetoma (fungal) to actinomycetoma (bacterial). Most cases are found in Mexico, India, and Sudan, where mycetoma is studied rigorously. We identified emergence of new geographical loci, including the United States, Venezuela, Italy, China, and Australia. Notably, mycetoma is reported far outside the tropics. In the Americas, bacterial forms dominate, whereas, in Africa and Asia, the picture is more varied. Conclusions With better understanding of the epidemiology of mycetoma, more can be done to direct education, preventive measures, and treatment to at-risk areas, enabling a reduction in disease burden.

Modelling the spatial distribution of mycetoma in Sudan

“… 11 , 12 In a recent review, mycetoma was noted to be present in 102 countries around the world and Sudan had the highest burden of cases. 13 More than 70 microorganisms have been incriminated in causing mycetoma and, according to the causative organism, it is classified into eumycetoma, caused by fungi, and actinomycetoma caused by bacteria. 14 , 15 Eumycetoma is frequently reported in Africa and India, whereas actinomycetoma is more predominant in Asia, and in Central and South America.…”

Phaeohyphomycotic pseudotumor of the right elbow caused by Trematosphaeria grisea

“…Although our patient denied staying in areas where T. grisea is endemic (Latin and South America), 7 he could have acquired the infection from a minor unrecognized trauma while traveling in Southern United States, close to the Mexican border. We speculate that the immune environment of the bursa, combined with long-term itraconazole treatment, prevented the formation of grains and full presentation of eumycetoma, resulting in the development of predominantly phaeohyphomycotic clinical and histopathologic features.…”

Eumycetoma Medical Treatment: Past, Current Practice, Latest Advances and Perspectives

“…boydii, and Sc. apiospermium [10][11][12]. The most common species that are responsible for more than 90% of the globally reported cases include M. mycetomatis, M. grisea, Sc.…”

“…The most common species that are responsible for more than 90% of the globally reported cases include M. mycetomatis, M. grisea, Sc. boydii, and L. senegalensis [10][11][12].…”