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Eumycetoma
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Eumycetoma
Eumycetoma, also known as Madura foot, is a persistent fungal infection of the skin and the tissues just under the skin, affecting most commonly the feet, although it can occur within other body parts. It starts as a painless wet nodule, which may be present for years before ulceration, swelling, bone degradation, and grainy discharge from sinuses and fistulae set in.
Many different species of fungi can cause eumycetoma, some examples include: Madurella mycetomatis, Falciformispora senegalensis, Curvularia lunata, Scedosporium species, Acremonium and Fusarium species. Diagnosis is normally done by histopathology and culture. Medical imaging may reveal extent of bone involvement. Other tests include ELISA, immunodiffusion, and Fungal DNA barcoding
Treatment includes surgical removal of affected tissue and antifungal medicines. After treatment, recurrence is common. Sometimes limb amputation is required.
The infection occurs generally in the tropics, and is endemic in Sub-Saharan Africa, especially Sudan, India, parts of South America and Mexico. Few cases have been reported across North Africa. Mycetoma is probably low-endemic to Egypt with predilection for eumycetoma. In 2016, the World Health Organization recognised eumycetoma as a neglected tropical disease.
The initial lesion is a small swelling under the skin following minor penetrating trauma (e.g stepping on broken glass) It appears as a painless wet nodule, which may be present for years before ulceration, swelling and weeping from sinuses, followed by bone deformity. The sinuses discharge a grainy liquid of fungal colonies. These grains are usually black or white. Destruction of deeper tissues, and deformity and loss of function in the affected limbs may occur in later stages. It tends to occur in one foot. Mycetoma due to bacteria has similar clinical features.
Eumycetoma is a type of mycetoma caused by fungi, distinct from mycetoma caused by bacteria from the phylum Actinomycetes; both have similar clinical features.
The most common fungi causing white discharge is Scedosporium (ex. Pseudoalleschia) boydii. Other causative agents of non-black grain eumycetoma include Acremonium and Fusarium species.
Black discharge tends to be caused by species from the genera Madurella, Pyrenochaeta, Exophiala, Leptosphaeria and Curvularia. The most common species are Madurella mycetomatis and Trematospheria grisea (previously called Madurella grisea).
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Eumycetoma
Eumycetoma, also known as Madura foot, is a persistent fungal infection of the skin and the tissues just under the skin, affecting most commonly the feet, although it can occur within other body parts. It starts as a painless wet nodule, which may be present for years before ulceration, swelling, bone degradation, and grainy discharge from sinuses and fistulae set in.
Many different species of fungi can cause eumycetoma, some examples include: Madurella mycetomatis, Falciformispora senegalensis, Curvularia lunata, Scedosporium species, Acremonium and Fusarium species. Diagnosis is normally done by histopathology and culture. Medical imaging may reveal extent of bone involvement. Other tests include ELISA, immunodiffusion, and Fungal DNA barcoding
Treatment includes surgical removal of affected tissue and antifungal medicines. After treatment, recurrence is common. Sometimes limb amputation is required.
The infection occurs generally in the tropics, and is endemic in Sub-Saharan Africa, especially Sudan, India, parts of South America and Mexico. Few cases have been reported across North Africa. Mycetoma is probably low-endemic to Egypt with predilection for eumycetoma. In 2016, the World Health Organization recognised eumycetoma as a neglected tropical disease.
The initial lesion is a small swelling under the skin following minor penetrating trauma (e.g stepping on broken glass) It appears as a painless wet nodule, which may be present for years before ulceration, swelling and weeping from sinuses, followed by bone deformity. The sinuses discharge a grainy liquid of fungal colonies. These grains are usually black or white. Destruction of deeper tissues, and deformity and loss of function in the affected limbs may occur in later stages. It tends to occur in one foot. Mycetoma due to bacteria has similar clinical features.
Eumycetoma is a type of mycetoma caused by fungi, distinct from mycetoma caused by bacteria from the phylum Actinomycetes; both have similar clinical features.
The most common fungi causing white discharge is Scedosporium (ex. Pseudoalleschia) boydii. Other causative agents of non-black grain eumycetoma include Acremonium and Fusarium species.
Black discharge tends to be caused by species from the genera Madurella, Pyrenochaeta, Exophiala, Leptosphaeria and Curvularia. The most common species are Madurella mycetomatis and Trematospheria grisea (previously called Madurella grisea).
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