Mycetoma: A report of 8 cases at tertiary care hospital in Central India with review of literature
Mycetoma cases in Central India
DOI:
https://doi.org/10.22122/cdj.v12i2.743Keywords:
Mycetoma, Tropical Disease, Actinomycetoma, EumycetomaAbstract
BACKGROUND: Mycetoma is introduced as a rare neglected disease in tropical areas. It is a chronic, localized, slowly progressive infectious granulomatous disease of soft tissue. It may be caused by true fungi such as eumycetoma or filamentous bacteria such as actinomycetoma. In India, there is variation in the species causing mycetoma according to geographical location. The purpose of this study was to review all currently available information to identify knowledge gaps and/or research priorities.
METHODS: The study was conducted retrospectively in the Department of Histopathology for biopsy-confirmed cases of mycetoma. Eight histopathologically confirmed cases were found in the two-year study period from 2018 to 2019, and a clinicopathological analysis of de-identified patient data was done.
RESULTS: Five cases were reported as mycotic mycetoma, and the rest were reported as actinomycosis. All patients were men, and the mean age of presentation was 41.37 years old. The foot, ankle, head, and neck were the sites that were the most infected regions.
CONCLUSION: Mycetoma is a rare disease but should be considered a differential diagnosis of any foot and ankle lump in a patient from the subtropics. An accurate and timely histopathological diagnosis is essential in mycetoma for its treatment and prognosis, as when left untreated, the disease progresses and leads to increased morbidity. Appropriate preventive and control measures can be utilized by health workers/community leaders to educate people at risk to reduce their exposure risk and report the cases as early as possible.
References
Zijlstra EE, van de Sande WW, Fahal AH. Mycetoma: A Long Journey from Neglect. PLoS Negl Trop Dis. 2016; 10(1): e0004244.
van de Sande WW. Global burden of human mycetoma: A systematic review and meta-analysis. PLoS Negl Trop Dis. 2013; 7(11): e2550.
Bonifaz A, Tirado-Sanchez A, Calderon L, Saul A, Araiza J, Hernandez M, et al. Mycetoma: Experience of 482 cases in a single center in Mexico. PLoS Negl Trop Dis. 2014; 8(8): e3102.
Zijlstra EE, van de Sande WWJ, Welsh O, Mahgoub ES, Goodfellow M, Fahal AH. Mycetoma: A unique neglected tropical disease. Lancet Infect Dis. 2016; 16(1): 100-12.
Fahal AH, Sabaa AH. Mycetoma in children in Sudan. Trans R Soc Trop Med Hyg. 2010; 104(2): 117-21.
Zarei MA, Zarrin M. Mycetomas in Iran: A review article. Mycopathologia. 2008; 165(3): 135-41.
Sawatkar GU, Narang T, Shiva Prakash MR, Daroach M, Sharma M, Nahar SU, et al. Aspergillus: An uncommon pathogen of eumycetoma. Dermatol Ther. 2017; 30(1). [Epub ahead of print].
Agarwal US, Besarwal RK, Gupta R, Agarwal P. Treatment of actinomycetoma foot--our experience with ten patients. J Eur Acad Dermatol Venereol. 2013; 27(12): 1505-13.
Hospenthal DR. Agents of mycetoma. In: Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: W.B. Saunders; 2015. p. 2929-33.
Venkatswami S, Sankarasubramanian A, Subramanyam S. The madura foot: Looking deep. Int J Low Extrem Wounds. 2012; 11(1): 31-42.
Sawatkar GU, Wankhade VH, Supekar BB, Singh RP, Bhat DM, Tankhiwale SS. Mycetoma: A common yet unrecognized health burden in central India. Indian Dermatol Online J. 2019; 10(3): 256-61.
Padhi S, Uppin SG, Uppin MS, Umabala P, Challa S, Laxmi V, et al. Mycetoma in South India: Retrospective analysis of 13 cases and description of two cases caused by unusual pathogens: Neoscytalidium dimidiatum and Aspergillus flavus. Int J Dermatol. 2010; 49(11): 1289-96.
Bakshi R, Mathur DR. Incidence and changing pattern of mycetoma in western Rajasthan. Indian J Pathol Microbiol. 2008; 51(1): 154-5.
Maiti PK, Ray A, Bandyopadhyay S. Epidemiological aspects of mycetoma from a retrospective study of 264 cases in West Bengal. Trop Med Int Health. 2002; 7(9): 788-92.
Dubey N, Capoor MR, Hasan AS, Gupta A, Ramesh V, Sharma S, et al. Epidemiological profile and spectrum of neglected tropical disease eumycetoma from Delhi, North India. Epidemiol Infect. 2019; 147: e294.
Chufal SS, Thapliyal NC, Gupta MK. An approach to histology-based diagnosis and treatment of Madura foot. J Infect Dev Ctries. 2012; 6(9): 684-8.
Nenoff P, van de Sande WW, Fahal AH, Reinel D, Schofer H. Eumycetoma and actinomycetoma--an update on causative agents, epidemiology, pathogenesis, diagnostics and therapy. J Eur Acad Dermatol Venereol. 2015; 29(10): 1873-83.
Relhan V, Mahajan K, Agarwal P, Garg VK. Mycetoma: An update. Indian J Dermatol. 2017; 62(4): 332-40.
Malone M, Gannass A, Bowling F. A chronic, destructive mycetoma infection in a diabetic foot in Saudi Arabia. Int J Low Extrem Wounds. 2011; 10(1): 12-5.
el Hassan AM, Fahal AH, Ahmed AO, Ismail A, Veress B. The immunopathology of actinomycetoma lesions caused by Streptomyces somaliensis. Trans R Soc Trop Med Hyg. 2001; 95(1): 89-92.
Salinas-Carmona MC, Perez-Rivera I. Humoral immunity through immunoglobulin M protects mice from an experimental actinomycetoma infection by Nocardia brasiliensis. Infect Immun. 2004; 72(10): 5597-604.
Verwer PE, Notenboom CC, Eadie K, Fahal AH, Verbrugh HA, van de Sande WW. A polymorphism in the chitotriosidase gene associated with risk of mycetoma due to madurella mycetomatis mycetoma-A retrospective study. PLoS Negl Trop Dis. 2015; 9(9): e0004061.
Agarwal P, Jagati A, Rathod SP, Kalra K, Patel S, Chaudhari M. Clinical features of mycetoma and the appropriate treatment options. Res Rep Trop Med. 2021; 12: 173-9.
Elkheir LYM, Haroun R, Mohamed MA, Fahal AH. Madurella mycetomatis causing eumycetoma medical treatment: The challenges and prospects. PLoS Negl Trop Dis. 2020; 14(8): e0008307.
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