Eumycetoma
Human and animal fungal infection / From Wikipedia, the free encyclopedia
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Eumycetoma, also known as Madura foot,[1][6] is a persistent fungal infection of the skin and the tissues just under the skin, affecting most commonly the feet, although it can occur in hands and other body parts.[5] It starts as a painless wet nodule, which may be present for years before ulceration, swelling, grainy discharge and weeping from sinuses and fistulae, followed by bone deformity.[3]
Eumycetoma | |
---|---|
Other names | Madura foot[1] |
An infected foot | |
Specialty | Infectious disease[2] |
Symptoms | Swelling, weeping pus filled sinuses, deformity.[3] |
Complications | Amputation |
Causes | Madurella spp., Falciformispora senegalensis, Curvularia lunata, Pseudallescheria spp., Neotestudina spp., Acremonium spp., Scedosporium spp. and Fusarium spp. [2] |
Diagnostic method | Microscopy, biopsy, culture,[3] medical imaging, ELISA, immunodiffusion, DNA sequencing[4] |
Differential diagnosis | Actinomycosis (Actinomycetoma)[3] |
Treatment | Surgical debridement, antifungal medicines[3] |
Medication | Itraconazole, posaconazole, voriconazole[4] |
Prognosis | Recurrence is common[5] |
Frequency | Endemic in Africa, India and South America[3] |
Several fungi can cause eumycetoma,[5] including: Madurella mycetomatis, Madurella grisea, Curvularia lunata, Scedosporium species, Acremonium and Fusarium species.[2] Diagnosis is by biopsy, visualising the fungi under the microscope and culture.[5] Medical imaging may reveal extent of bone involvement.[4] Other tests include ELISA, immunodiffusion, and DNA Barcoding.[4]
Treatment includes surgical removal of affected tissue and antifungal medicines.[3] After treatment, recurrence is common.[5] Sometimes amputation is required.[5]
The infection occurs generally in the tropics,[7] and is endemic in Sub-Saharan Africa, especially Sudan, India, parts of South America and Mexico.[3] Few cases have been reported across North Africa.[8][9] Mycetoma is probably low-endemic to Egypt with predilection for eumycetoma.[10] In 2016, the World Health Organization recognised eumycetoma as a neglected tropical disease.[7]