Eumycetoma
| Eumycetoma | |
|---|---|
| Other names | Madura foot |
| An infected foot | |
| Specialty | Infectious disease |
| Symptoms | Swelling, weeping pus filled sinuses, deformity. |
| Complications | Amputation, secondary infections |
| Causes | Many different species of fungi such as: Madurella spp., Falciformispora senegalensis, Curvularia lunata, Pseudallescheria spp., Neotestudina spp., Acremonium spp., Scedosporium spp. and Fusarium spp. |
| Diagnostic method | Microscopy, biopsy, culture, medical imaging, ELISA, immunodiffusion, Fungal DNA barcoding |
| Differential diagnosis | Actinomycosis (Actinomycetoma) |
| Treatment | Surgical debridement, antifungal medicines |
| Medication | Itraconazole, posaconazole, voriconazole |
| Prognosis | Recurrence is common |
| Frequency | Endemic in Africa, India and South America |
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 in hands and other body parts. 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.
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 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.