Mycetoma Follow-up

  • Author: Basilio J Anía, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Jul 22, 2011
 

Further Outpatient Care

Patients with mycetoma should receive maintained medical treatment and follow-up care for at least 10 months.

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Deterrence/Prevention

Educate patients to avoid activities that expose them to agents of mycetoma. Instruct patients to avoid carrying sticks and thorny branches that have had contact with the soil.

The glycolytic enzyme fructose-bisphosphate aldolase (FBA) is expressed on the hyphae present in the mycetoma grain. FBA antibody levels were found to be significantly higher in eumycetoma patient sera when compared with healthy Sudanese controls. Therefore, FBA might be useful as candidate antigen for a future vaccine against mycetoma.[17]

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Complications

  • Complications of mycetoma result mainly from toxicity due to prolonged administration of antimicrobial or antifungal drugs.
  • Amputation may result from neglected chronic infections.
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Prognosis

  • Mycetoma carries a good prognosis if the disease is promptly diagnosed and treated. Although mycetoma carries a low risk of mortality, amputations or ankylosis can lessen the quality of life.
  • In late stages of mycetoma, the treatment response is limited.
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Contributor Information and Disclosures
Author

Basilio J Anía, MD  Associate Professor of Infectious Diseases, Universidad de Las Palmas de Gran Canaria; Consultant in Internal Medicine, Hospital Universitario Dr. Negrín, Spain

Disclosure: Nothing to disclose.

Coauthor(s)

Margarita Asenjo, MD  Associate Professor, Department of Radiology, Medical School of the University of Las Palmas De Gran Canaria, Spain

Disclosure: Nothing to disclose.

Raphael J Kiel, MD  Associate Professor of Medicine, Wayne State University School of Medicine; Associate Professor of Medicine, Oakland University William Beaumont School of Medicine; Consulting Staff, Infectious Diseases Division, William Beaumont Hospital; Consulting Staff, Infectious Diseases Division Providence Hospital

Raphael J Kiel, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine and American Geriatrics Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Michael Stuart Bronze, MD  Professor, Stewart G Wolf Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Association of Professors of Medicine, Association of Program Directors in Internal Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

  1. Hospenthal DR. Agents of Mycetoma. In: Mandell GL, Bennett JE, Dolin R. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 2. 7th. Philadelphia, PA (U.S.A.): Churchill Livingstone Elsevier; 2010:3281-3285.

  2. Rouphael NG, Talati NJ, Franco-Paredes C. A painful thorn in the foot: a case of eumycetoma. Am J Med Sci. Aug 2007;334(2):142-4. [Medline].

  3. Bakshi R, Mathur DR. Incidence and changing pattern of mycetoma in western Rajasthan. Indian J Pathol Microbiol. Jan-Mar 2008;51(1):154-5. [Medline].

  4. Ahmed AO, van Leeuwen W, Fahal A, et al. Mycetoma caused by Madurella mycetomatis: a neglected infectious burden. Lancet Infect Dis. Sep 2004;4(9):566-74. [Medline].

  5. Abd El-Bagi ME, Fahal AH. Mycetoma revisited. Incidence of various radiographic signs. Saudi Med J. Apr 2009;30(4):529-33. [Medline].

  6. Kumar J, Kumar A, Sethy P, et al. The dot-in-circle sign of mycetoma on MRI. Diagn Interv Radiol. Dec 2007;13(4):193-5. [Medline]. [Full Text].

  7. Yousif BM, Fahal AH, Shakir MY. A new technique for the diagnosis of mycetoma using fixed blocks of aspirated material. Trans R Soc Trop Med Hyg. Jan 2010;104(1):6-9. [Medline].

  8. Hemalata M, Prasad S, Venkatesh K, Niveditha SR, Kumar SA. Cytological diagnosis of actinomycosis and eumycetoma: a report of two cases. Diagn Cytopathol. Dec 2010;38(12):918-20. [Medline].

  9. Ahmed AA, van de Sande WW, Fahal A, et al. Management of mycetoma: major challenge in tropical mycoses with limited international recognition. Curr Opin Infect Dis. Apr 2007;20(2):146-51. [Medline].

  10. Falkson C, Sur R, Pacella J. External beam radiotherapy: a treatment option for massive haemoptysis caused by mycetoma. Clin Oncol (R Coll Radiol). Jun 2002;14(3):233-5. [Medline].

  11. Damle DK, Mahajan PM, Pradhan SN, Belgaumkar VA, Gosavi AP, Tolat SN, et al. Modified Welsh regimen: a promising therapy for actinomycetoma. J Drugs Dermatol. Sep 2008;7(9):853-6. [Medline].

  12. Baril L, Boiron P, Manceron V, et al. Refractory craniofacial actinomycetoma due to Streptomyces somaliensis that required salvage therapy with amikacin and imipenem. Clin Infect Dis. Aug 1999;29(2):460-1. [Medline].

  13. Ramam M, Bhat R, Garg T, et al. A modified two-step treatment for actinomycetoma. Indian J Dermatol Venereol Leprol. Jul-Aug 2007;73(4):235-9. [Medline].

  14. Fahal AH, Rahman IA, El-Hassan AM, Rahman ME, Zijlstra EE. The safety and efficacy of itraconazole for the treatment of patients with eumycetoma due to Madurella mycetomatis. Trans R Soc Trop Med Hyg. Mar 2011;105(3):127-32. [Medline].

  15. van Belkum A, Fahal AH, van de Sande WW. In vitro susceptibility of Madurella mycetomatis to posaconazole and terbinafine. Antimicrob Agents Chemother. Apr 2011;55(4):1771-3. [Medline]. [Full Text].

  16. van de Sande WW, Fahal AH, Bakker-Woudenberg IA, van Belkum A. Madurella mycetomatis is not susceptible to the echinocandin class of antifungal agents. Antimicrob Agents Chemother. Jun 2010;54(6):2738-40. [Medline]. [Full Text].

  17. de Klerk N, de Vogel C, Fahal A, van Belkum A, van de Sande WW. Fructose-bisphosphate aldolase and pyruvate kinase, two novel immunogens in Madurella mycetomatis. Med Mycol. Jul 5 2011;[Medline].

  18. Abd El Bagi ME. New radiographic classification of bone involvement in pedal mycetoma. AJR Am J Roentgenol. Mar 2003;180(3):665-8. [Medline].

  19. Akhtar MA, Latief PA. Actinomycetoma pedis. Postgrad Med J. Nov 1999;75(889):671. [Medline].

  20. Bapat KC, Pandit AA. Actinomycotic mycetoma. Report of a case with diagnosis by fine needle aspiration. Acta Cytol. Nov-Dec 1991;35(6):770-2. [Medline].

  21. Boiron P, Locci R, Goodfellow M, et al. Nocardia, nocardiosis and mycetoma. Med Mycol. 1998;36 Suppl 1:26-37. [Medline].

  22. Bouza E, Munoz P. Invasive infections caused by Blastoschizomyces capitatus and Scedosporium spp. Clin Microbiol Infect. Mar 2004;10 Suppl 1:76-85. [Medline].

  23. Campagnaro EL, Woodside KJ, Early MG, et al. Disseminated Pseudallescheria boydii (Scedosporium apiospermum) infection in a renal transplant patient. Transpl Infect Dis. Dec 2002;4(4):207-11. [Medline].

  24. Chaveiro MA, Vieira R, Cardoso J, et al. Cutaneous infection due to Scedosporium apiospermum in an immunosuppressed patient. J Eur Acad Dermatol Venereol. Jan 2003;17(1):47-9. [Medline].

  25. Chávez G, Estrada R, Bonifaz A. Perianal actinomycetoma experience of 20 cases. Int J Dermatol. Aug 2002;41(8):491-3. [Medline].

  26. Coukell AJ, Brogden RN. Liposomal amphotericin B. Therapeutic use in the management of fungal infections and visceral leishmaniasis. Drugs. Apr 1998;55(4):585-612. [Medline].

  27. Develoux M, Dieng MT, Kane A, et al. [Management of mycetoma in West-Africa]. Bull Soc Pathol Exot. Jan 2003;96(5):376-82. [Medline].

  28. Dieng MT, Sy MH, Diop BM, et al. [Mycetoma: 130 cases]. Ann Dermatol Venereol. Jan 2003;130(1 Pt 1):16-9. [Medline].

  29. EL Hag IA, Fahal AH, Gasim ET. Fine needle aspiration cytology of mycetoma. Acta Cytol. May-Jun 1996;40(3):461-4. [Medline].

  30. Fahal AH. Mycetoma: a thorn in the flesh. Trans R Soc Trop Med Hyg. Jan 2004;98(1):3-11. [Medline].

  31. Fahal AH, Hassan MA. Mycetoma. Br J Surg. Nov 1992;79(11):1138-41. [Medline].

  32. Fahal AH, Sheik HE, Homeida MM, et al. Ultrasonographic imaging of mycetoma. Br J Surg. Aug 1997;84(8):1120-2. [Medline].

  33. Fletcher CL, Moore MK, Hay RJ. Eumycetoma due to Madurella mycetomatis acquired in Jamaica. Br J Dermatol. Dec 2001;145(6):1018-21. [Medline].

  34. Greenberg AK, Knapp J, Rom WN, et al. Clinical presentation of pulmonary mycetoma in HIV-infected patients. Chest. Sep 2002;122(3):886-92. [Medline].

  35. Hay RJ. Fungal infections. In: Cook GC, ed. Manson's Tropical Diseases. 20th ed. London, UK: WB Saunders; 1996:1047-74.

  36. Hay RJ, Moore M. Mycology. In: Champion RH, Wilkinson DS, Ebling FJG, Breathnach SM, eds. Rook/Wilkinson/Ebling Textbook of Dermatology. Vol 2. 6th ed. Oxford, UK: Blackwell Science; 1998:1277-376.

  37. Khatri ML, Al-Halali HM, Fouad Khalid M, et al. Mycetoma in Yemen: clinicoepidemiologic and histopathologic study. Int J Dermatol. Sep 2002;41(9):586-93. [Medline].

  38. Lichon V, Khachemoune A. Mycetoma : a review. Am J Clin Dermatol. 2006;7(5):315-21. [Medline].

  39. Mahgoub ES. Medical management of mycetoma. Bull World Health Organ. 1976;54(3):303-10. [Medline].

  40. Maiti PK, Ray A, Bandyopadhyay S. Epidemiological aspects of mycetoma from a retrospective study of 264 cases in West Bengal. Trop Med Int Health. Sep 2002;7(9):788-92. [Medline].

  41. Mellinghoff IK, Winston DJ, Mukwaya G, et al. Treatment of Scedosporium apiospermum brain abscesses with posaconazole. Clin Infect Dis. Jun 15 2002;34(12):1648-50. [Medline].

  42. Mendez-Tovar LJ, Mondragon-Gonzalez R, Manzano-Gayosso P, et al. [Immunoglobulins in patients with Nocardia brasiliensis actinomycetoma]. Rev Argent Microbiol. Oct-Dec 2004;36(4):174-8. [Medline].

  43. O'Bryan TA. Pseudallescheriasis in the 21st century. Expert Rev Anti Infect Ther. Oct 2005;3(5):765-73. [Medline].

  44. Poncio Mendes R, Negroni R, Bonifaz A, et al. New aspects of some endemic mycoses. Med Mycol. 2000;38 Suppl 1:237-41. [Medline].

  45. Queiroz-Telles F, McGinnis MR, Salkin I, et al. Subcutaneous mycoses. Infect Dis Clin North Am. Mar 2003;17(1):59-85, viii. [Medline].

  46. Ramam M, Garg T, D'Souza P, et al. A two-step schedule for the treatment of actinomycotic mycetomas. Acta Derm Venereol. Sep-Oct 2000;80(5):378-80. [Medline].

  47. Saag MS. Mycetoma. In: Goldman L, Bennett JC, eds. Cecil Textbook of Medicine. ed. Philadelphia, Pa: WB Saunders; 2000:1885-7.

  48. Saarinen KA, Lestringant GG, Czechowski J, et al. Cutaneous nocardiosis of the chest wall and pleura--10-year consequences of a hand actinomycetoma. Dermatology. 2001;202(2):131-3. [Medline].

  49. Sharma N, Mendiratta V, Sharma RC, et al. Pulse therapy with amikacin and dapsone for the treatment of actinomycotic foot: a case report. J Dermatol. Oct 2003;30(10):742-7. [Medline].

 
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Mycetoma in a 47-year-old shepherd from Mauritania who had a painless progressive swelling of the face for more than 20 years.
Frontal view of mycetoma in a 47-year-old shepherd from Mauritania who had a painless progressive swelling of the face for more than 20 years.
MRI coronal section of mycetoma in a 47-year-old shepherd from Mauritania who had a painless progressive swelling of the face for more than 20 years. On this T1-potentiated image, a large heterogenous mass surrounds the cranium. Bone invasion can be observed only in the area of the zygomatic fossa.
MRI with coronal view of mycetoma in a 47-year-old shepherd from Mauritania who had a painless progressive swelling of the face for more than 20 years. The mycetoma mass invades the left parapharyngeal space and almost reaches the lumen of the pharynx.
 
 
 
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