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Kashikar Y, Kashikar S, Madke B, Meghe S, Rusia K. Dot in circle sign on MRI in foot mycetoma. Radiol Case Rep 2024; 19:1960-1964. [PMID: 38434776 PMCID: PMC10909609 DOI: 10.1016/j.radcr.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 01/28/2024] [Accepted: 02/03/2024] [Indexed: 03/05/2024] Open
Abstract
Mycetoma or Maduramycosis is a chronic granulomatous infectious condition encountered mostly in tropical and subtropical regions. It affects the deep subcutaneous tissues, which may progress to involve the muscles and bones later in the course of the disease. It can be caused by fungi (eumycetoma), and bacteria (actinomycetoma) predominantly affecting the foot. Demonstration of the causative agent by biopsy and microbiological studies helps to establish a confirmative diagnosis, and choosing correct antimicrobial therapy. However, it may be delayed resulting in increased patient morbidity. Thus, imaging plays a vital role in early recognition & prompt treatment, especially MRI which is a non-invasive procedure demonstrating the hallmark dot in circle sign. Here we report a case of mycetoma foot with pathognomic MRI findings.
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Affiliation(s)
- Yash Kashikar
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
| | - Shivali Kashikar
- Department of Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
| | - Bhushan Madke
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
| | - Soham Meghe
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
| | - Kaveri Rusia
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
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2
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Omar Ali H, Abraham R, Desoubeaux G, Fahal AH, Tauber C. Evaluation of a computational model for mycetoma-causative agents identification. Trans R Soc Trop Med Hyg 2024; 118:253-263. [PMID: 38088215 DOI: 10.1093/trstmh/trad057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/21/2023] [Accepted: 11/27/2023] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The therapeutic strategy for mycetoma relies heavily on the identification of the causative agents, which are either fungal or bacterial. While histopathological examination of surgical biopsies is currently the most used diagnostic tool, it requires well-trained pathologists, who are lacking in most rural areas where mycetoma is endemic. In this work we propose and evaluate a machine learning approach that semi-automatically analyses histopathological microscopic images of grains and provides a classification of the disease as eumycetoma or actinomycetoma. METHODS The computational model is based on radiomics and partial least squares. It is assessed on a dataset that includes 890 individual grains collected from 168 patients originating from the Mycetoma Research Centre in Sudan. The dataset contained 94 eumycetoma cases and 74 actinomycetoma cases, with a distribution of the species among the two causative agents that is representative of the Sudanese distribution. RESULTS The proposed model achieved identification of causative agents with an accuracy of 91.89%, which is comparable to the accuracy of experts from the domain. The method was found to be robust to a small error in the segmentation of the grain and to changes in the acquisition protocol. Among the radiomics features, the homogeneity of mycetoma grain textures was found to be the most discriminative feature for causative agent identification. CONCLUSION The results presented in this study support that this computational approach could greatly benefit rural areas with limited access to specialized clinical centres and also provide a second opinion for expert pathologists to implement the appropriate therapeutic strategy.
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Affiliation(s)
- Hyam Omar Ali
- Faculty of Mathematical Sciences, University of Khartoum, 11111, Khartoum, Sudan
- Mycetoma Research Centre, University of Khartoum, 11111, Khartoum, Sudan
- Boulevard Tonnellé, University of Tours, Inserm, 37032, Tours, France
- CNRS U7013, rue de Chartres, University of Orleans, 45067, Orleans, France
| | - Romain Abraham
- CNRS U7013, rue de Chartres, University of Orleans, 45067, Orleans, France
| | - Guillaume Desoubeaux
- Parasitology and Mycology Department, Bretonneau Hospital, 37032, Tours, France
- Boulevard Tonnellé, University of Tours, 37032, Tours, France
| | - Ahmed H Fahal
- Mycetoma Research Centre, University of Khartoum, 11111, Khartoum, Sudan
| | - Clovis Tauber
- Boulevard Tonnellé, University of Tours, Inserm, 37032, Tours, France
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3
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Izquierdo-Condoy JS, Vásconez-Gonzáles J, Morales-Lapo E, Tello-De-la-Torre A, Naranjo-Lara P, Fernández R, Hidalgo MR, Escobar A, Yépez VH, Díaz AM, Oliva C, Ortiz-Prado E. Beyond the acute phase: a comprehensive literature review of long-term sequelae resulting from infectious diseases. Front Cell Infect Microbiol 2024; 14:1293782. [PMID: 38357446 PMCID: PMC10864624 DOI: 10.3389/fcimb.2024.1293782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Infectious diseases have consistently served as pivotal influences on numerous civilizations, inducing morbidity, mortality, and consequently redirecting the course of history. Their impact extends far beyond the acute phase, characterized by the majority of symptom presentations, to a multitude of adverse events and sequelae that follow viral, parasitic, fungal, or bacterial infections. In this context, myriad sequelae related to various infectious diseases have been identified, spanning short to long-term durations. Although these sequelae are known to affect thousands of individuals individually, a comprehensive evaluation of all potential long-term effects of infectious diseases has yet to be undertaken. We present a comprehensive literature review delineating the primary sequelae attributable to major infectious diseases, categorized by systems, symptoms, and duration. This compilation serves as a crucial resource, illuminating the long-term ramifications of infectious diseases for healthcare professionals worldwide. Moreover, this review highlights the substantial burden that these sequelae impose on global health and economies, a facet often overshadowed by the predominant focus on the acute phase. Patients are frequently discharged following the resolution of the acute phase, with minimal long-term follow-up to comprehend and address potential sequelae. This emphasizes the pressing need for sustained vigilance, thorough patient monitoring, strategic health management, and rigorous research to understand and mitigate the lasting economic and health impacts of infectious diseases more fully.
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Mohanan S, M V, Carounanidy U, C S B. Botryomycosis with compressive brachial plexus neuropathy: A rare tropical disease with dermato-neurological association. Indian J Dermatol Venereol Leprol 2024; 90:99-102. [PMID: 37317767 DOI: 10.25259/ijdvl_1005_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/18/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Saritha Mohanan
- Department of Dermatology, Indira Gandhi Medical College and Research Institute, Puducherry, India
| | - Vijaikumar M
- Department of Skin and STD, Indira Gandhi Government General Hospital and Post Graduate Institute, Puducherry, India
| | - Udayashankar Carounanidy
- Department of Dermatology, Indira Gandhi Medical College and Research Institute, Puducherry, India
| | - Banushree C S
- Department of Pathology, Indira Gandhi Medical College and Research Institute, Puducherry, India
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Liu J, Xu Z, Bai Y, Feng J, Xu L, Li F. Streptomyces albireticuli lung infection managed as a pulmonary air cyst: a case report and literature review. Front Cell Infect Microbiol 2024; 13:1296491. [PMID: 38274731 PMCID: PMC10808341 DOI: 10.3389/fcimb.2023.1296491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Streptomyces, the largest genus in the Streptomycetaceae family and a prolific producer of antibacterial drugs, is a saprophytic soil organism that rarely causes invasive infections. Here we report a case of necrotic pneumonia caused by Streptomyces albireticuli in a 75-year-old man who presented with progressive chest tightness and dyspnea. Streptomyces albireticuli was isolated from his bronchoalveolar lavage fluid and identified through whole-genome sequencing (WGS) and phylogenetic analysis. The patient responded satisfactorily to clarithromycin therapy. The findings of this study may enhance our vigilance in identifying visceral infections caused by Streptomyces.
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Affiliation(s)
- Jiajiao Liu
- Department of Neurosurgery, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Critical Care Medicine, The General Hospital of Western Theatre Command Chinese People's Liberation Army (PLA), Chengdu, China
| | - Zhaoxia Xu
- Department of Emergency Department, The General Hospital of Western Theatre Command Chinese People's Liberation Army (PLA), Chengdu, China
| | - Yujie Bai
- Department of Critical Care Medicine, The General Hospital of Western Theatre Command Chinese People's Liberation Army (PLA), Chengdu, China
| | - Jian Feng
- Department of Critical Care Medicine, The General Hospital of Western Theatre Command Chinese People's Liberation Army (PLA), Chengdu, China
| | - Lunshan Xu
- Department of Neurosurgery, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Fuxiang Li
- Department of Critical Care Medicine, The General Hospital of Western Theatre Command Chinese People's Liberation Army (PLA), Chengdu, China
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Doğan A, Ali AM, Ali MA, Abdullahi İM. Mycetoma case series in Somalia. Trop Doct 2024; 54:42-44. [PMID: 37715653 DOI: 10.1177/00494755231201664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Mycetoma is a suppurative chronic bacterial or fungal disease inoculated into the body by minor trauma which may penetrate from subcutaneous tissue to bone. Although the lower extremities are most commonly affected, rare forms can also be seen from time to time. The diagnostic triad of swelling in the affected area, multiple sinus formation, and purulent discharge with grains are typical. Definitive diagnosis is made by isolation of the causative pathogen, radiologic imaging, and histopathologic examination. Antifungal and antibacterial options are applied together with surgery. Our aim in this case series is to report and analyze 10 rare cases of mycetoma.
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Affiliation(s)
- Ahmet Doğan
- Department of İnfectious Diseases and Clinical Microbiology, Mogadishu-Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - Ahmed Mohamed Ali
- Department of İnfectious Diseases and Clinical Microbiology, Mogadishu-Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - Mukhtar Abdullahi Ali
- Department of İnfectious Diseases and Clinical Microbiology, Mogadishu-Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
| | - İsmail Mohamoud Abdullahi
- Department of Medical Pathology, Mogadishu-Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia
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Hashizume H, Taga S, Sakata MK, Hussein M, Siddig EE, Minamoto T, Fahal AH, Kaneko S. Environmental detection of eumycetoma pathogens using multiplex real-time PCR for soil DNA in Sennar State, Sudan. Trop Med Health 2023; 51:71. [PMID: 38115141 PMCID: PMC10729560 DOI: 10.1186/s41182-023-00563-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/09/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Mycetoma is a chronic disease affecting the skin and subcutaneous tissue endemic in the tropical and subtropical regions. Several bacteria and fungi can cause mycetoma, but fungal mycetoma (eumycetoma) is challenging because the treatment requires a combination of a long-term antifungal agent and surgery. Although the transmission route has not yet been elucidated, infection from the soil is a leading hypothesis. However, there are few soil investigation studies, and the geographical distribution of mycetoma pathogens is not well documented. Here, we used multiplex real-time PCR technology to identify three fungal species from soil samples. METHODS In total, 64 DNA samples were extracted from soil collected in seven villages in an endemic area in Sennar State, Sudan, in 2019. Primers and fluorescent probes specifically targeting the ribosomal DNA of Madurella mycetomatis, Falciformispora senegalensis, and F. tompkinsii were designed. RESULTS Multiplex real-time PCR was performed and identified the major pathogen, M. mycetomatis that existed in most sites (95%). In addition, two other pathogens were identified from some sites. This is the first report on the use of this technique for identifying the eumycetoma causative microorganisms. CONCLUSIONS This study demonstrated that soil DNA investigation can elucidate the risk area of mycetoma-causative agents. The results will contribute to the design of prevention measures, and further large-scale studies may be effective in understanding the natural habitats of mycetoma pathogens.
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Affiliation(s)
- Hiroki Hashizume
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Department of Ecoepidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Suguru Taga
- Department of Ecoepidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Masayuki K Sakata
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-Ku, Kobe, 657-8501, Japan
- Research Faculty of Agriculture, Hokkaido University, Kita-9, Nishi-9, Kita-Ku, Sapporo, Hokkaido, 060-8589, Japan
| | - Mahmoud Hussein
- Mycetoma Research Center, University of Khartoum, P.O. Box 102, Khartoum, Sudan
- Tumors Therapy and Cancer Research Center, Molecular Biology Unit, Shendi University, P.O .Box 142-143, Shendi, Sudan
| | - Emmanuel Edwar Siddig
- Mycetoma Research Center, University of Khartoum, P.O. Box 102, Khartoum, Sudan
- Faculty of Medical Laboratory Sciences, Unit of Basic Medical Sciences, University of Khartoum, Khartoum, Sudan
| | - Toshifumi Minamoto
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-Ku, Kobe, 657-8501, Japan
| | - Ahmed Hassan Fahal
- Mycetoma Research Center, University of Khartoum, P.O. Box 102, Khartoum, Sudan
| | - Satoshi Kaneko
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
- Department of Ecoepidemiology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
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Chhabra N, Sri P, Ganguly S. Linezolid: a safer and effective substitute to aminoglycoside in the treatment of actinomycetoma by Nocardia species. Int J Dermatol 2023; 62:1160-1163. [PMID: 37366290 DOI: 10.1111/ijd.16764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/31/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
Actinomycetoma is chronic, suppurative, granulomatous infection caused by bacteria and requires prolonged antibiotic therapy preferrably in combinations. Nephrotoxicity is a common side effect of aminoglycosides used in the management of actinomycetoma. We report here two cases of actinomycetoma due to Nocardia species who received linezolid as a substitute to aminoglycosides after developing nephrotoxicity.
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Affiliation(s)
- Namrata Chhabra
- Department of Dermatology, All India Institute of Medical Sciences, Raipur, 492099, Chhattisgarh, India
| | - Preethaa Sri
- Department of Dermatology, All India Institute of Medical Sciences, Raipur, 492099, Chhattisgarh, India
| | - Satyaki Ganguly
- Department of Dermatology, All India Institute of Medical Sciences, Raipur, 492099, Chhattisgarh, India
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John TJ, Kompithra RZ. Eco-epidemiology triad to explain infectious diseases. Indian J Med Res 2023; 158:107-112. [PMID: 37675687 PMCID: PMC10645024 DOI: 10.4103/ijmr.ijmr_3031_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Indexed: 09/08/2023] Open
Affiliation(s)
- T. Jacob John
- Formerly Department of Clinical Virology, Christian Medical College, Vellore 632 004, Tamil Nadu, India
- Formerly Department of Clinical Microbiology, Christian Medical College, Vellore 632 004, Tamil Nadu, India
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Colom MF, Ferrer C, Ekai JL, Ferrández D, Ramírez L, Gómez-Sánchez N, Leting S, Hernández C. First report on mycetoma in Turkana County-North-western Kenya. PLoS Negl Trop Dis 2023; 17:e0011327. [PMID: 37578968 PMCID: PMC10449206 DOI: 10.1371/journal.pntd.0011327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/24/2023] [Accepted: 07/18/2023] [Indexed: 08/16/2023] Open
Abstract
Mycetoma is one of the six Neglected Tropical Diseases that are prevalent in Turkana County (northwest Kenya). The aim of the study was to estimate the prevalence of mycetoma in the county, as well as to describe the main causative agents involved in the disease using methods affordable locally. Based on the data collected by the team of cooperative medicine Cirugia en Turkana (Surgery in Turkana), a specific study for mycetoma was started during the 16th humanitarian medicine campaign in February 2019. Patients with suspected mycetoma were studied at the Lodwar County Referral Hospital (LCRH). After informing the patient and getting their consent, the lesions were examined and sampled (mainly by biopsy) and clinical data were recorded. Samples were washed in sterile saline solution and cut in fragments. Some of these were inoculated on Sabouraud Dextrose Agar, Malt Extract Agar, and diluted Nutrient Agar plates. One fragment of each sample was used for DNA extraction. The DNA and the rest of the fragments of samples were kept at -20°C. All cultures were incubated at room temperature at the LCRH laboratory. The DNA obtained from clinical samples was submitted to PCR amplification of the ITS-5.8S and the V4-V5 16S rRNA gene region, for the detection and identification of fungi and bacteria respectively. From February 2019 till February 2022, 60 patients were studied. Most of them were men (43, 74,1%) between 13 and 78 y.o. (mean age 37). Half of the patients were herdsmen but, among women 40% (6) were housewives and 26.7% (4) charcoal burners. Lesions were mainly located at the feet (87.9%) and most of the patients (54; 93.1%) reported discharge of grains in the exudate, being 27 (46.6%) yellow or pale colored and 19 (32.8%) of them dark grains. Culture of clinical samples yielded 35 fungal and bacterial putative causative agents. Culture and molecular methods allowed the identification of a total of 21 causative agents of mycetoma (39.6% of cases studied). Most of them (17) corresponded to fungi causing eumycetoma (80.9%) being the most prevalent the genus Madurella (7; 41.2%), with two species involved (M. mycetomatis and M. fahalii), followed by Aspergillus (2; 11.8%). Other minority genera detected were Cladosporium, Fusarium, Acremonium, Penicillium, and Trichophyton (5.9% each of them). Actinobacteria were detected in 19.1% of samples, but only Streptomyces somaliensis was identified as a known agent of mycetoma, the rest being actinobacteria not previously described as causative agents of the disease, such as Cellulosimicrobium cellulans detected in two of the patients. Although Kenya is geographically located in the mycetoma belt, to our knowledge this is the first report on mycetoma in this country from 1973, and the first one for Turkana County.
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Affiliation(s)
- María Francisca Colom
- Laboratory of Medical Mycology, Universidad Miguel Hernández, Avenida Santiago Ramón y Cajal s/n, Edificio Muhammad Al Shafra, Sant Joan d’Alacant, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- NGO Medical direction, Cirugía en Turkana (Surgery in Turkana), Madrid, Spain
| | - Consuelo Ferrer
- Laboratory of Medical Mycology, Universidad Miguel Hernández, Avenida Santiago Ramón y Cajal s/n, Edificio Muhammad Al Shafra, Sant Joan d’Alacant, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - John Lochuke Ekai
- Medical Diagnosis Laboratory, Lodwar County and Referral Hospital, Turkana, Kenya
| | - David Ferrández
- Laboratory of Medical Mycology, Universidad Miguel Hernández, Avenida Santiago Ramón y Cajal s/n, Edificio Muhammad Al Shafra, Sant Joan d’Alacant, Spain
| | - Laura Ramírez
- Laboratory of Medical Mycology, Universidad Miguel Hernández, Avenida Santiago Ramón y Cajal s/n, Edificio Muhammad Al Shafra, Sant Joan d’Alacant, Spain
| | - Noelia Gómez-Sánchez
- Laboratory of Medical Mycology, Universidad Miguel Hernández, Avenida Santiago Ramón y Cajal s/n, Edificio Muhammad Al Shafra, Sant Joan d’Alacant, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Simion Leting
- Medical Diagnosis Laboratory, Lodwar County and Referral Hospital, Turkana, Kenya
| | - Carmen Hernández
- NGO Medical direction, Cirugía en Turkana (Surgery in Turkana), Madrid, Spain
- San Carlos University Hospital, Madrid, Spain
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Tolat A, Kalwaniya DS, Sharma A, Kumar D, Rana S, Ahluwalia C. A Detailed Review of Surgical Management of Uncommon Cutaneous Disorders. Cureus 2023; 15:e36763. [PMID: 37123679 PMCID: PMC10132855 DOI: 10.7759/cureus.36763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
A variety of cutaneous disorders can present to the general surgeon either directly or by referral for surgical intervention. Some conditions are commonly seen and operated on by general surgeons which include lipoma, epidermoid cyst, etc. On the other hand, some are uncommon conditions like dermatofibrosarcoma protuberans and chondroid syringoma which require a high index of suspicion to diagnose. Most general surgeons are not familiar with the latest guidelines to treat such uncommon conditions. In this article, we provide a review of uncommon cutaneous disorders requiring surgical intervention that were encountered at our high-volume tertiary care center and a discussion about their etiology, presentation, diagnosis, management and follow-up with one case report of each condition. The objective of this article is to familiarize the general surgeon with these cutaneous disorders which though uncommon, will present in their practice at some point.
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Kuzucular E, Eren A, Isik E, Ozden F. Mycetoma (Madura foot): A Case Report of a Rare Tropical Disease in Turkey. INT J LOW EXTR WOUND 2023:15347346231156642. [PMID: 36814397 DOI: 10.1177/15347346231156642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Mycetoma is a chronic discharging infection involving the skin, subcutaneous tissue, fascia, and bone, which is endemic in tropical and subtropical countries. We report a rare case of mycetoma localized on the foot of a patient living in a country with a temperate climate. A 32-year-old male patient presented with painless swelling in the right foot. He had undergone surgery 3 years ago with the same complaints. Magnetic resonance imaging revealed a 90 × 65 × 37 mm cystic soft tissue lesion in the posterior of the right ankle. Histological analysis identified the fungus. Extensive resection was performed. Mycetoma is characterized by chronic granulomatous inflammatory response, often associated with sinus tract formations due to fungal (eumycetoma) or bacterial (actinomycetoma) organisms. Here we provide a literature review and highlight the importance of increasing awareness toward mycetoma, particularly in non-endemic regions.
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Affiliation(s)
- Elif Kuzucular
- Department of Pathology, 218502Istanbul Medipol University, Turkey
| | - Abdulkadir Eren
- Department of Radiology, 218502Istanbul Medipol University, Turkey
| | - Eray Isik
- Department of Plastic and Reconstructive Surgery, 218502Istanbul Medipol University, Turkey
| | - Ferhat Ozden
- Department of Pathology, 218502Istanbul Medipol University, Turkey
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Husain U, Verma P, Suvirya S, Priyadarshi K, Gupta P. An overview of mycetoma and its diagnostic dilemma: Time to move on to advanced techniques. Indian J Dermatol Venereol Leprol 2023; 89:12-17. [PMID: 36331840 DOI: 10.25259/ijdvl_615_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/01/2022] [Indexed: 02/01/2023]
Abstract
The neglected tropical disease mycetoma can become extremely devastating, and can be caused both by fungi and bacteria; these are popularly known as eumycetoma and actinomycetoma respectively. The classical triad of the disease is subcutaneous swelling, multiple discharging sinuses and the presence of macroscopic granules. The present study aims to highlight the existing diagnostic modalities and the need to incorporate newer and more advanced laboratory techniques like pan fungal/pan bacterial 16S rRNA gene polymerase chain reaction (PCR) and sequencing, Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), rolling circle amplification (RCA), loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA). It is important for the medical team to be aware of the various diagnostic options (both existing and future), so that diagnosis of such a debilitating disease is never missed, both by clinicians and microbiologists/pathologists. The newer diagnostic methods discussed in this article will help in rapid, accurate diagnosis thus facilitating early treatment initiation, and decreasing the overall morbidity of the disease. In the Indian context, newer technologies need to be made available more widely. Making clinicians aware and promoting research and development in mycetoma diagnostics is the need of the hour.
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Affiliation(s)
- Uneza Husain
- Department of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Parul Verma
- Department of Dermatology, Venereology, and Leprosy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Swastika Suvirya
- Department of Dermatology, Venereology, and Leprosy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ketan Priyadarshi
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Prashant Gupta
- Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Arteaga D, Tirado-Sánchez A, Vázquez-González D, Moreno LM, van de Sande W, Bonifaz A. Encapsulated eumycetoma caused by Biatriospora mackinnonii. Med Mycol Case Rep 2022; 38:1-4. [PMID: 36160296 PMCID: PMC9489879 DOI: 10.1016/j.mmcr.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/21/2022] [Accepted: 08/28/2022] [Indexed: 11/23/2022] Open
Abstract
Eumycetoma is a chronic infection due to filamentous fungi. Herein, we report a case of eumycetoma presenting as a subcutaneous encapsulated lesion on the right leg with no previous traumatic implantation. From microscopic morphological characteristics and molecular analysis, the pathogenic fungal species were identified as Biatriospora mackinnonii. Surgical excision of the entire lesion was performed to reduce the fungal load and improve antifungal therapy response.
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Affiliation(s)
- Daniela Arteaga
- Dermatology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, 06720, Mexico
| | - Andrés Tirado-Sánchez
- Dermatology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, 06720, Mexico
| | - Denisse Vázquez-González
- Dermatology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, 06720, Mexico
| | - Luis-Miguel Moreno
- Dermatopathology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, 06720, Mexico
| | - Wendy van de Sande
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, 3015, the Netherlands
| | - Alexandro Bonifaz
- Dermatology Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City, 06720, Mexico
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15
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Hoogervorst LA, op de Coul LS, Ray A, de Witte PB, de Boer MGJ. Mycetoma caused by Madurella mycetomatis in immunocompromised patients – a case report and systematic literature review. J Bone Jt Infect 2022; 7:241-248. [DOI: 10.5194/jbji-7-241-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/10/2022] [Indexed: 11/22/2022] Open
Abstract
Abstract. The aim of this study was to review the available literature
concerning Madura foot (“mycetoma”) caused by Madurella mycetomatis in immunocompromised
patients. With a systematic literature search, we identified only three
papers, describing a total of three immunocompromised patients. Hence, the clinical presentation and prognosis of the disease in this patient
population have not yet been well described. In addition, we present a case from our institution, illustrating the complexity of the treatment of this
rare disease. Although very rare in non-endemic countries, we emphasize that
mycetoma should be included in the differential diagnoses of (immunocompromised) patients who have been residing in a geographical area
where the disease is endemic and presenting with soft tissue inflammation of
one of the extremities.
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16
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Abd Algaffar SO, Verbon A, Khalid SA, van de Sande WWJ. Development and validation of a resazurin assay for in vitro susceptibility testing of Actinomadura madurae: a common causative agent of actinomycetoma. J Antimicrob Chemother 2022; 78:155-160. [PMID: 36315595 PMCID: PMC9780526 DOI: 10.1093/jac/dkac367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/07/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Actinomycetoma is a chronic granulomatous disease affecting skin, subcutaneous tissue, fascia, muscle and bones. With increasing resistance against commonly used treatment regimens, susceptibility testing is urgently needed. METHODS We developed an in vitro susceptibility assay for Actinomadura madurae, one of the common causative agents of actinomycetoma, employing resazurin for endpoint reading. Using this assay, reproducible MICs were determined for the most commonly used antibacterial agents for actinomycetoma treatment. The tested antibacterial agents included trimethoprim/sulfamethoxazole, amikacin, streptomycin, amoxicillin, ceftriaxone, gentamicin, ciprofloxacin, doxycycline, imipenem, linezolid, penicillin G and rifampicin. RESULTS Following the clinical breakpoints as stated by CLSI, 100% of the tested strains were susceptible to trimethoprim/sulfamethoxazole (MIC 0.03/0.59-1/19 mg/L), amikacin (MIC 0.0078-0.25 mg/L), doxycycline (MIC <0.25-1 mg/L) and linezolid (MIC <0.25-2 mg/L), 90% to ciprofloxacin (MIC <0.25-2 mg/L), 80% to ceftriaxone (MIC <0.5 to >64 mg/L) and imipenem (MIC <0.25-32 mg/L) and only 20% to amoxicillin (MIC <0.5 to >64 mg/L) and rifampicin (MIC 0.5 to >32 mg/L). CONCLUSIONS Determinations of MICs by visual readings of colour changes versus spectrophotometric readings were comparable. This convenient visual reading has the advantage of feasible implementation in endemic settings.
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Affiliation(s)
- S O Abd Algaffar
- Faculty of Pharmacy, University of Science & Technology, Omdurman, Sudan
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - A Verbon
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - S A Khalid
- Faculty of Pharmacy, University of Science & Technology, Omdurman, Sudan
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Taneja J, Passi S, Ranjan R, Abbas SZ, Ramesh V. Mycetoma by Nocardia blacklockiae: The first case. Indian J Med Microbiol 2022. [DOI: 10.1016/j.ijmmb.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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18
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Ansari F, Singh S, Bhardwaj A, Budania A, Bains A, Nalwa A, Khera S, Elhence P, Patel A, Yadav T, Khera P. Clinical triad with multi‐biopsy histopathology as a reliable diagnostic marker of mycetomas: a retrospective review from a tertiary care center. Int J Dermatol 2022; 62:88-96. [DOI: 10.1111/ijd.16384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/11/2022] [Accepted: 07/27/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Farzana Ansari
- Department of Dermatology, Venereology & Leprology AIIMS Jodhpur Jodhpur India
| | - Saurabh Singh
- Department of Dermatology, Venereology & Leprology AIIMS Jodhpur Jodhpur India
| | - Abhishek Bhardwaj
- Department of Dermatology, Venereology & Leprology AIIMS Jodhpur Jodhpur India
| | - Anil Budania
- Department of Dermatology, Venereology & Leprology AIIMS Jodhpur Jodhpur India
| | - Anupama Bains
- Department of Dermatology, Venereology & Leprology AIIMS Jodhpur Jodhpur India
| | - Aasma Nalwa
- Department of Pathology AIIMS Jodhpur Jodhpur India
| | - Sudeep Khera
- Department of Pathology AIIMS Jodhpur Jodhpur India
| | | | - Ankur Patel
- Department of Radiology AIIMS Bhopal Bhopal India
| | - Taruna Yadav
- Department of Radiology AIIMS Jodhpur Jodhpur India
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19
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Hassan R, Deribe K, Simpson H, Bremner S, Elhadi O, Alnour M, Fahal AH, Newport M, Bakhiet S. Individual Risk Factors of Mycetoma Occurrence in Eastern Sennar Locality, Sennar State, Sudan: A Case-Control Study. Trop Med Infect Dis 2022; 7:tropicalmed7080174. [PMID: 36006266 PMCID: PMC9412883 DOI: 10.3390/tropicalmed7080174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Mycetoma is a serious chronic subcutaneous granulomatous inflammatory disease that is endemic in tropical and subtropical regions, where it impacts profoundly on patients, families, and communities. Individual-level risk factors for the disease are poorly understood. To address this, a case-control study was conducted based on data collected from 60 villages in Eastern Sennar Locality, Sennar State, Sudan. Based on the presence of swelling in any part of the body, or sinus formation with or without grain discharge evident from the lesion by ultrasound examination, we diagnosed 359 cases of mycetoma. For each case, we included three healthy sex-matched persons, with no evidence of mycetoma, from the same village as the control group (n = 1077). The odds for mycetoma were almost three times higher in individuals in the age group 16–30 years (Adjusted Odds Ratio (AOR) = 2.804, 95% CI = 1.424–5.523) compared to those in age group ≤ 15 years. Other factors contributing to the odds of mycetoma were history of local trauma (AOR = 1.892, 95% CI = 1.425–2.513), being unmarried (AOR = 3.179, 95% CI = 2.339–4.20) and owning livestock (AOR = 3.941, 95% CI = 2.874–5.405). In conclusion, certain factors found to be associated with mycetoma in this study could inform a high index of suspicion for mycetoma diagnosis, which would improve early case detection. Other factors found to be associated could inform the development of an interventional program for mycetoma control in Sudan, including education on healthy farming practices and the risks of puncture wounds for individuals residing in endemic areas. However, this work was conducted in one endemic state, while mycetoma cases occur in all states of Sudan. Replicating this study over a wider area would give a fuller picture of the situation, providing the control program with more comprehensive information on the risk factors for the disease.
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Affiliation(s)
- Rowa Hassan
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
- Correspondence:
| | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
- Children’s Investment Fund Foundation, Addis Ababa P.O. Box 9086, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia
| | - Hope Simpson
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Stephen Bremner
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
| | - Osama Elhadi
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
| | - Mustafa Alnour
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
- Department of Radiography, Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | - Ahmed Hassan Fahal
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
| | - Melanie Newport
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
| | - Sahar Bakhiet
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum 11111, Sudan
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20
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Cerrillos‐Gutiérrez JI, Ramírez‐Flores D, Gutiérrez‐Govea A, Andrade‐Sierra J, Medina‐Pérez M, Rojas‐Campos E. Mycetoma by Actinomadura madurae in the central nervous system: Renal transplant receptor disease. Clin Case Rep 2022; 10:e6071. [PMID: 35898749 PMCID: PMC9309743 DOI: 10.1002/ccr3.6071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/11/2022] [Accepted: 06/28/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- José Ignacio Cerrillos‐Gutiérrez
- Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre Mexican Institute of Social Security Guadalajara Jalisco Mexico
| | - Diana Ramírez‐Flores
- Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre Mexican Institute of Social Security Guadalajara Jalisco Mexico
| | - Alfredo Gutiérrez‐Govea
- Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre Mexican Institute of Social Security Guadalajara Jalisco Mexico
- University Health Sciences Center University of Guadalajara Guadalajara Jalisco Mexico
| | - Jorge Andrade‐Sierra
- Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre Mexican Institute of Social Security Guadalajara Jalisco Mexico
| | - Miguel Medina‐Pérez
- Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Centre Mexican Institute of Social Security Guadalajara Jalisco Mexico
- University Health Sciences Center University of Guadalajara Guadalajara Jalisco Mexico
| | - Enrique Rojas‐Campos
- Medical Research Unit in Renal Diseases, Specialties Hospital, National Western Medical Centre Mexican Institute of Social Security Guadalajara Jalisco Mexico
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21
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Hutabarat EN, Ilyas F, Amin S. Eumycetoma Pedis Due to Madurella mycetomatis in Indonesian Farmer: A Case Report. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Mycetoma is a chronic, localized cutaneous inflammatory disease originating from fungi (eumycetoma) or bacteria (actinomycetoma) infection. The most common cause of eumycetoma is a black grain producing fungus, Madurella mycetoma.
CASE PRESENTATION: We present a case of eumycetoma pedis in a middle-aged woman with a successful resolution after receiving the combination of surgical debridement, systemic itraconazole, and topical antifungals therapy.
CONCLUSION: This case report highlights the importance of a prompt diagnostic procedure to identify the causative agent in mycetoma at an early stage of the disease followed by integrated management care that combines systemic therapy and surgical intervention.
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22
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Tarafdar S, Kanimozhi P, Sabarish S, Nagarajan K, Thappa DM, Laxmisha C. Magnetic Resonance Imaging in the Diagnosis of Mycetoma with Equivocal Clinical and Laboratory Features. Indian J Dermatol 2022; 67:459-463. [PMID: 36578749 PMCID: PMC9792037 DOI: 10.4103/ijd.ijd_124_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Swarnava Tarafdar
- From the Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research JIPMER, Pondicherry, India E-mail:
| | - Periasamy Kanimozhi
- From the Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research JIPMER, Pondicherry, India E-mail:
| | - Sekar Sabarish
- From the Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research JIPMER, Pondicherry, India E-mail:
| | - Krishnan Nagarajan
- From the Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research JIPMER, Pondicherry, India E-mail:
| | - Devinder M. Thappa
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research JIPMER, Pondicherry, India
| | - Chandrashekar Laxmisha
- Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research JIPMER, Pondicherry, India
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23
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López DM, Blasco AP, Ferrer LG, Camarena JJ, González R, Perez JLR. [Eumycetomas by Fusarium oxysporum and Madurella mycetomatis. Description of two cases and literature review]. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2022; 35:566-569. [PMID: 36243950 PMCID: PMC9728604 DOI: 10.37201/req/027.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Diego Martínez López
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia.,Correspondencia: Diego Martínez López Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia. E-mail:
| | - Antonio Pérez Blasco
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia
| | - Luis García Ferrer
- Servico de Radiodiagnóstico, Hospital Universitario Doctor Peset, Valencia
| | - Juan J Camarena
- Servicio de Microbiología Clínica Hospital Universitario Doctor Peset, Valencia.,Universidad de Valencia
| | - Rosa González
- Servicio de Microbiología Clínica Hospital Universitario Doctor Peset, Valencia.,Universidad de Valencia
| | - José Luis Rodrigo Perez
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia.,Universidad de Valencia
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Hassan R, Deribe K, Fahal AH, Newport M, Bakhiet S. Clinical epidemiological characteristics of mycetoma in Eastern Sennar locality, Sennar State, Sudan. PLoS Negl Trop Dis 2021; 15:e0009847. [PMID: 34898611 PMCID: PMC8699598 DOI: 10.1371/journal.pntd.0009847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/23/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022] Open
Abstract
Mycetoma epidemiological features remain uncharacterised. Few studies have been conducted in a community-based setting to explore the epidemiological features and risk factors for mycetoma in Sudan. To bridge this gap, this study was conducted in Eastern Sennar Locality, Sennar State, Sudan, to report the clinical, epidemiological characteristics of mycetoma patients and the disease burden in the state. We used cluster sampling; sixty villages were randomly selected across the locality's five administrative units, and a household-to-household survey was conducted. We collected data using pre-designed questionnaires at the community, household, and individual levels. We performed descriptive analyses of the data and produced prevalence maps using ArcGIS 10.5 ([ESRI] Inc., Redlands CA, USA). A total of 41,176 individuals were surveyed, and 359 mycetoma patients were identified. The overall prevalence of mycetoma was 0.87% (95%CI = 0.78-0.97%), the prevalence among males was 0.83% (95%CI = 0.71-0.96%), and females 0.92% (95% CI = 0.79-1.06%). Individuals in the age group 31-45 years had the highest prevalence among the different age groups (1.52%, 95% CI = 1.23-1.86%). The prevalence map showed patients clustered within the central and north-eastern part of the locality, while villages in the south-western part had few or no cases. In conclusion, this clinical epidemiological study is pioneering and shows that mycetoma is prevalent in certain parts of Sudan. This data obtained will support the design of measures to reduce the disease burden in the state. The survey procedures and protocols can be adopted for further studies in Sudan and beyond.
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Affiliation(s)
- Rowa Hassan
- Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
- Children’s Investment Fund Foundation, Addis Ababa, Ethiopia
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Melanie Newport
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Sahar Bakhiet
- Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan
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25
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Sahu BK, Nag HL. An Illustrative Report of Three Cases of Madura Foot with Diagnostic and Treatment Features. J Orthop Case Rep 2021; 11:74-78. [PMID: 35415109 PMCID: PMC8930322 DOI: 10.13107/jocr.2021.v11.i11.2522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/22/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Madura foot is a rare infective granulomatous foot disease. The burden of this disease has significantly declined in recent years due to better generalized living conditions. Hence, the diagnosis can be quite often missed by the new generation orthopedic surgeon for other more similar conditions. Early diagnosis and prompt treatment is crucial for better outcome and limb survival. We here present the clinical picture of three such Madura foot cases. Case Series In this study, three Indian males aged between 40 and 60 years of rural background presented to our department with chronic multiple discharging sinuses of the foot. They were initially treated for several months in their local health centers without any improvement. Finally, they came to our institution where they were thoroughly inspected and underwent various investigations such as magnetic resonance imaging (MRI) and histopathological examination. They were referred across various departments such as dermatology, general surgery and orthopedics, and eventually got correct diagnosis. Treatment was promptly started with oral itraconazole, an antifungal drug, and one patient undergoing additional surgical debulking of the disease which lead to gradual healing of the disease as evident by disappearance of sinuses and return of normal skin in 6-12 months. Conclusion Madura foot is very characteristic, although it may mimic more prevalent infectious conditions. The characteristic multiple discharging sinuses with extrusions of sulphur granules and MRI findings of "dot in circle" should clinch the diagnosis quickly. Medical therapy should be continued for at least 12 months even if there is resolution of disease in the early or mid-phase of treatment. Debulking of the disease will aid in early recovery and reduce abnormal swelling or appearance of the foot.
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Affiliation(s)
- Binay Kumar Sahu
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.,
Address of Correspondence: Dr. Binay Kumar Sahu, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi - 110029, India. E-mail:
| | - Hira Lal Nag
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
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26
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Hassan R, Simpson H, Cano J, Bakhiet S, Ganawa E, Argaw D, Newport MJ, Deribe K, Fahal AH. Modelling the spatial distribution of mycetoma in Sudan. Trans R Soc Trop Med Hyg 2021; 115:1144-1152. [PMID: 34037803 PMCID: PMC8486737 DOI: 10.1093/trstmh/trab076] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/18/2021] [Accepted: 04/26/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Mycetoma is a neglected tropical disease that is reported worldwide and Sudan has the highest reported number of mycetoma infections across the globe. The incidence, prevalence and burden of mycetoma globally are not precisely known and its risk factors remain largely unelucidated. METHODS This study aimed to identify the environmental predictors of fungal and bacterial mycetoma in Sudan and to identify areas of the country where these niche predictors are met. Demographic and clinical data from confirmed mycetoma patients seen at the Mycetoma Research Centre from 1991 to 2018 were included in this study. Regression and machine learning techniques were used to model the relationships between mycetoma occurrence in Sudan and environmental predictors. RESULTS The strongest predictors of mycetoma occurrence were aridity, proximity to water, low soil calcium and sodium concentrations and the distribution of various species of thorny trees. The models predicted the occurrence of eumycetoma and actinomycetoma in the central and southeastern states of Sudan and along the Nile river valley and its tributaries. CONCLUSION Our results showed that the risk of mycetoma in Sudan varies geographically and is linked to identifiable environmental risk factors. Suitability maps are intended to guide health authorities, academic institutes and organisations involved in planning national scale surveys for early case detection and management, leading to better patient treatment, prevention and control of mycetoma.
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Affiliation(s)
- Rowa Hassan
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum, 11111, Sudan
- Department of Global Health and Infection, Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, UK
| | - Hope Simpson
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Jorge Cano
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Sahar Bakhiet
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum, 11111, Sudan
| | - Eltayeb Ganawa
- Department of GIS and Cartography, Faculty of Geography and Environmental Sciences, University of Khartoum, Khartoum, 11111, Sudan
| | - Daniel Argaw
- World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland
| | - Melanie J Newport
- Department of Global Health and Infection, Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, UK
| | - Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, UK
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmed Hassan Fahal
- Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Khartoum, 11111, Sudan
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27
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Sarawagi R, Sharma J, Malik R, Kumar A. Spinal Eumycetoma: A Rare Cause of Lumbar Canal Stenosis and Significance of "Dot in Circle". Indian J Radiol Imaging 2021; 31:468-471. [PMID: 34556932 PMCID: PMC8448220 DOI: 10.1055/s-0041-1734331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Mycetoma is a chronic granulomatous disease that is more common in tropical regions with predominant involvement of foot. Spinal mycetoma presenting as lumbar canal stenosis is extremely rare. We hereby present a case of fungal eumycetoma of vertebral column in a 42-year-old male who presented with chronic progressive low back pain and features of lumbar canal stenosis without any skin swelling or discharging sinuses. The “dot-in-circle” sign, a highly specific magnetic resonance imaging (MRI) and ultrasonography (USG) sign of mycetoma has been described in the literature as a pathognomonic feature of mycetoma involving the musculoskeletal system. We describe the importance of characteristic imaging features with dot in circle sign in the diagnosis of eumycetoma of lumbar spine.
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Affiliation(s)
- Radha Sarawagi
- Department of Radio Diagnosis and Imaging, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Jitendra Sharma
- Department of Radio Diagnosis and Imaging, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Rajesh Malik
- Department of Radio Diagnosis and Imaging, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Aman Kumar
- Department of Radio Diagnosis and Imaging, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Aróstegui Aguilar J, Diago A, Carrillo Gijón R, Fernández Figueras M, Fraga J, García Herrera A, Garrido M, Idoate Gastearena M, Christian Laga A, Llamas-Velasco M, Martínez Campayo N, Monteagudo C, Onrubia J, Pérez Muñoz N, Ríos-Martín J, Ríos-Viñuela E, Rodríguez Peralto J, Rozas Muñoz E, Sanmartín O, Santonja C, Santos-Briz A, Saus C, Suárez Peñaranda J, Velasco Benito V, Beato Merino M, Fernandez-Flores A. Granulomas in Dermatopathology: Principal Diagnoses — Part 2. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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29
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Gupta A, Sharma DN, Gupta S, Sharma S, Dev T, Singh S, Mücke R, Micke O. Treatment of refractory mycetoma by radiotherapy: a case study and review. PRECISION RADIATION ONCOLOGY 2021. [DOI: 10.1002/pro6.1125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Anil Gupta
- All India Institute of Medical Sciences Department of Radiotherapy Ansari Nagar New Delhi India
| | - Daya Nand Sharma
- All India Institute of Medical Sciences Department of Radiotherapy Ansari Nagar New Delhi India
| | - Somesh Gupta
- All India Institute of Medical Sciences Department of Dermatology & Venereology New Delhi India
| | - Seema Sharma
- All India Institute of Medical Sciences Department of Radiotherapy Ansari Nagar New Delhi India
| | - Tanvi Dev
- All India Institute of Medical Sciences Department of Dermatology & Venereology New Delhi India
| | - Suvesh Singh
- All India Institute of Medical Sciences Department of Dermatology & Venereology New Delhi India
| | - Ralph Mücke
- RheinMain University of Applied Sciences Department of Radiotherapy Bad Kreuznach Hessen Germany
| | - Oliver Micke
- Franziskus Hospital Bielefeld Department of Radiotherapy and Radiation Oncology Bielefeld Nordrhein‐Westfalen Germany
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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; 12:173-179. [PMID: 34267575 PMCID: PMC8275212 DOI: 10.2147/rrtm.s282266] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/05/2021] [Indexed: 11/23/2022] Open
Abstract
Mycetoma is a chronic, suppurative and debilitating granulomatous infection seen mainly in tropical and subtropical areas and is now declared as a neglected tropical disease by the World Health Organization. The clinical diagnosis is usually characterized by a classical triad of localized swelling, underlying sinus tracts, and production of grains or granules, but unusual presentations are also seen. It is classified into eumycetoma caused by the fungus, and actinomycetoma caused by the bacteria. The clinical presentation of both is almost similar and a definite diagnosis is essential before starting the treatment as it differs for both. Surgical debulking followed by a prolonged course of medical therapy now forms the mainstay of treatment due to the long course of the disease and suboptimal response. This review focuses on the various usual as well as unusual clinical presentations of mycetoma, established treatment regimens as well as recent changes in the mode of administration of drugs and newer drugs for mycetoma.
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Affiliation(s)
- Pooja Agarwal
- Department of Dermatology, Smt. SCL Hospital, Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
| | - Ashish Jagati
- Department of Dermatology, Smt. SCL Hospital, Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
| | - Santoshdev P Rathod
- Department of Dermatology, Smt. SCL Hospital, Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
| | - Kirti Kalra
- Department of Dermatology, Smt. SCL Hospital, Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
| | - Shefali Patel
- Department of Dermatology, Smt. SCL Hospital, Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
| | - Malay Chaudhari
- Department of Dermatology, Smt. SCL Hospital, Smt. N.H.L. Municipal Medical College, Ahmedabad, Gujarat, India
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31
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Tsoi MF, Kline MA, Conkling A, Mani R, Corner SM. Scedosporium apiospermum infection presenting as a mural urinary bladder mass and focal peritonitis in a Border Collie. Med Mycol Case Rep 2021; 33:9-13. [PMID: 34189027 PMCID: PMC8217339 DOI: 10.1016/j.mmcr.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/22/2021] [Accepted: 05/29/2021] [Indexed: 11/19/2022] Open
Abstract
Scedosporium apiospermum is an opportunistic mold that is an emerging disease in humans and animals. This report describes a case of S. apiospermum infection inciting a mural urinary bladder mass and focal peritonitis in a dog that had a history of multiple traumatic events several years prior. For diagnosis, culture followed by MALDI-ToF, PCR, and sequencing was performed to accurately identify the species. Susceptibility testing was also performed due to the inherent resistance of S. apiospermum to numerous antifungal agents.
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Affiliation(s)
- Mayra F Tsoi
- Veterinary Diagnostic Laboratory, Michigan State University, Lansing, MI, USA
| | | | | | - Rinosh Mani
- Veterinary Diagnostic Laboratory, Michigan State University, Lansing, MI, USA
| | - Sarah M Corner
- Veterinary Diagnostic Laboratory, Michigan State University, Lansing, MI, USA
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32
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Siddig EE, Nyuykonge B, Ahmed MT, Hassan R, Saad ESA, Mhmoud NA, Bakhiet SM, van de Sande WWJ, Fahal AH. Human actinomycetoma caused by Actinomadura mexicana in Sudan: the first report. Trans R Soc Trop Med Hyg 2021; 115:406-410. [PMID: 33382899 DOI: 10.1093/trstmh/traa145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/09/2020] [Accepted: 11/08/2020] [Indexed: 11/14/2022] Open
Abstract
Mycetoma is a localized, chronic, granulomatous disease that can be caused by fungi (eumycetoma) or bacteria (actinomycetoma). Of the 70 different causative agents implicated in mycetoma worldwide, Actinomadura madurae is the only one that causes multiple cases on all continents. Recently, new Actinomadura species were described as causative agents of human mycetoma. One of these new causative agents was Actinomadura mexicana, which was identified in Latin America. Here we demonstrate that this causative agent is not confined to Latin America and that it is also a causative agent of actinomycetoma in Sudan. The disease was managed by antibiotic treatment alone and resulted in complete cure after 6 months of treatment, which is quick when compared with actinomycetoma cases caused by other Actinomadura species.
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Affiliation(s)
- Emmanuel Edwar Siddig
- Mycetoma Research Centre, University of Khartoum, P.O. Box 102, Khartoum, Sudan.,Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Bertrand Nyuykonge
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | - Rowa Hassan
- Mycetoma Research Centre, University of Khartoum, P.O. Box 102, Khartoum, Sudan.,Brighton and Sussex Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, UK
| | | | - Najwa Adam Mhmoud
- Mycetoma Research Centre, University of Khartoum, P.O. Box 102, Khartoum, Sudan
| | - Sahar Mubarak Bakhiet
- Mycetoma Research Centre, University of Khartoum, P.O. Box 102, Khartoum, Sudan.,Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Wendy W J van de Sande
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Ahmed Hassan Fahal
- Mycetoma Research Centre, University of Khartoum, P.O. Box 102, Khartoum, Sudan
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33
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Kébé M, Ba O, Mohamed Abderahmane MA, Mohamed Baba ND, Ball M, Fahal A. A study of 87 mycetoma patients seen at three health facilities in Nouakchott, Mauritania. Trans R Soc Trop Med Hyg 2021; 115:315-319. [PMID: 33580966 DOI: 10.1093/trstmh/traa197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/29/2020] [Accepted: 12/22/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Mycetoma is a chronic, progressive and destructive inflammatory disease that affects the skin, subcutaneous and other tissues. The objective of this study was to identify all cases of mycetoma diagnosed in three health facilities in Nouakchott, Mauritania during 2016-2018. METHODS This retrospective hospital-based study was conducted at the Dermatology, Orthopedics, Mycology and Pathology departments of the National Hospital Center of Nouakchott, the Military Hospital of Nouakchott and the National Institute for Research in Public Health of Nouakchott. RESULTS Eighty-seven patients were included in this study. They comprised 65 male patients (74.71%) and 22 females (25.28%) with a gender ratio of 4:1. The mean age was 41.87 y and ages ranged from 14 to 70 y. The most common age group was 40-45 y (11%). The foot was the most frequently affected site seen in 60 patients (69%), followed by ankle and hand with 6 patients each (7%). In the study, 56 patients (64%) had regional lymphadenopathy. Forty-nine patients (56%) had bone involvement. Thirty-two patients (37%) had medical treatment. Twenty-seven patients (87%) received fluconazole and four patients (13%) had co-trimoxazole treatment. CONCLUSION The mycetoma patients seen in these three centres were mainly male farmers from rural areas. The lesions were seen mainly in the lower limbs and the majority had bone involvement radiologically.
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Affiliation(s)
- M Kébé
- Department of Dermatology, National Hospital Center, Nouakchott, Mauritania
| | - O Ba
- National Institute for Public Health Research, Nouakchott, Mauritania
| | | | - N D Mohamed Baba
- Histopathology Department, National Hospital Center, Nouakchott, Mauritania
| | - M Ball
- Department of Dermatology, National Hospital Center, Nouakchott, Mauritania
| | - A Fahal
- Mycetoma Research Center, Khartoum, Sudan
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34
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Dayrit JF, Sugiharto A, Coates SJ, Lucero-Prisno DE, Davis MDD, Andersen LK. Climate change, human migration, and skin disease: is there a link? Int J Dermatol 2021; 61:127-138. [PMID: 33971021 DOI: 10.1111/ijd.15543] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023]
Abstract
Climate change, exemplified by higher average global temperatures resulting in more frequent extreme weather events, has the potential to significantly impact human migration patterns and health. The consequences of environmental catastrophes further destabilize regions with pre-existing states of conflict due to social, political, and/or economic unrest. Migrants may carry diseases from their place of origin to their destinations and once there may be susceptible to diseases in which they had not been previously exposed to. Skin diseases are among the most commonly observed health conditions observed in migrant populations. To improve awareness among dermatologists of the burden of skin diseases among migrants, the group searched the English language scientific literature to identify articles linking climate change, migration, and skin disease. Skin diseases associated with human migration fall into three major categories: (i) communicable diseases, (ii) noncommunicable diseases, and (iii) environmentally mediated diseases. Adopting comprehensive global strategies to improve the health of migrants requires urgent attention.
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Affiliation(s)
- Johannes F Dayrit
- De La Salle University Medical and Health Sciences Institute, Dasmarinas City, Philippines.,Department of Dermatology, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Audi Sugiharto
- Department of Dermatology, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Sarah J Coates
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Louise K Andersen
- Department of Dermatology, Aleris-Hamlet Private Hospitals, Esbjerg, Denmark
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35
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Aróstegui Aguilar J, Diago A, Carrillo Gijón R, Fernández Figueras M, Fraga J, García Herrera A, Garrido M, Idoate Gastearena MA, Christian Laga A, Llamas-Velasco M, Martínez Campayo N, Monteagudo C, Onrubia J, Pérez Muñoz N, Ríos-Martín JJ, Ríos-Viñuela E, Rodríguez Peralto JL, Rozas Muñoz E, Sanmartín O, Santonja C, Santos-Briz A, Saus C, Suárez Peñaranda JM, Velasco Benito V, Beato Merino MJ, Fernandez-Flores A. Granulomas in Dermatopathology: Principal Diagnoses - Part 2. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:S0001-7310(21)00138-1. [PMID: 33891884 DOI: 10.1016/j.ad.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022] Open
Abstract
Part 2 of this series on granulomatous diseases focuses on skin biopsy findings. Whereas the first part treated noninfectious conditions (metabolic disorders and tumors, among other conditions), this part mainly deals with various types of infectious disease along with other conditions seen fairly often by clinical dermatologists.
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Affiliation(s)
- J Aróstegui Aguilar
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España
| | - A Diago
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - R Carrillo Gijón
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, España
| | - M Fernández Figueras
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, España
| | - J Fraga
- Servicio de Anatomía Patológica, Hospital Universitario de La Princesa, Madrid, España
| | - A García Herrera
- Servicio de Anatomía Patológica, Hospital Clínic, Barcelona, España
| | - M Garrido
- Departamento de Anatomía Patológica, Hospital Universitario 12 de Octubre, Universidad Complutense, Instituto de Investigación I+12, Madrid, España
| | - M A Idoate Gastearena
- Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Departamento de Citología, Histología y Anatomía Patológica, Facultad de Medicina, Universidad de Sevilla, Sevilla, España
| | - A Christian Laga
- Departamento de Patología, Brigham and Women's Hospital, Boston, Massachusetts, Estados Unidos
| | - M Llamas-Velasco
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España
| | - N Martínez Campayo
- Servicio de Dermatología, Complejo Hospitalario Universitario A Coruña, A Coruña, España
| | - C Monteagudo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Facultad de Medicina, Universidad de Valencia, Valencia, España
| | - J Onrubia
- Servicio de Anatomía Patológica, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España
| | - N Pérez Muñoz
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Quirón salud, Sant Cugat del Vallès, Barcelona, España
| | - J J Ríos-Martín
- Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - E Ríos-Viñuela
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - J L Rodríguez Peralto
- Departamento de Anatomía Patológica, Hospital Universitario 12 de Octubre, Universidad Complutense, Instituto de Investigación I+12, Madrid, España
| | - E Rozas Muñoz
- Departamento de Dermatología, Hospital de San Pablo, Coquimbo, Chile
| | - O Sanmartín
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - C Santonja
- Servicio de Anatomía Patológica, Fundación Jiménez Díaz, Madrid, España
| | - A Santos-Briz
- Servicio de Anatomía Patológica, Hospital Universitario de Salamanca, Salamanca, España
| | - C Saus
- Servicio de Anatomía Patológica. Hospital Universitario Son Espases, Palma de Mallorca, España
| | - J M Suárez Peñaranda
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España
| | - V Velasco Benito
- Servicio de Anatomía Patológica, Hospital Universitario de Cruces, Barakaldo, Vizcaya, España
| | - M J Beato Merino
- Servicio de Anatomía Patológica, Hospital Universitario La Paz, Madrid, España
| | - A Fernandez-Flores
- Servicio de Anatomía Patológica, Hospital Universitario El Bierzo, Ponferrada, León, España; Servicio de Anatomía Patológica, Hospital de la Reina, Ponferrada, León, España; Unidad de Investigación, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidad de A Coruña, A Coruña, España.
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Das L, Dahiya D, Gupta K, Prakash M, Malhotra B, Rastogi A, Choudhary H, Rudramurthy SM, Dutta P. Eumycetoma of the Foot due to Fusarium solani in a Person with Diabetes Mellitus: Report of a Case and Review of Literature. Mycopathologia 2021; 186:277-288. [PMID: 33687638 DOI: 10.1007/s11046-020-00524-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/21/2020] [Indexed: 10/20/2022]
Abstract
Eumycetomas are chronic suppurative granulomas caused by fungi characterised by invasive tumefactive lesions, sinuses and discharging grains. Herein, we describe a case of pedal eumycetoma due to Fusarium solani sensu stricto in a person with diabetes mellitus. A 45-year-old gentleman presented with an insidious onset swelling over his right foot with nodules and discharging grains. He had received itraconazole and anti-tuberculous therapy elsewhere, without response. Re-evaluation included a biopsy which confirmed eumycetoma and newly diagnosed diabetes. Surgical excision followed by histopathological, microbiological and multigene sequencing analyses [translation elongation factor, calmodulin and internal transcribed spacer region of rDNA] of the mould on culture were performed. Histopathology revealed septate fungal hyphae amidst a dense inflammatory infiltrate (Splendore-Hoeppli) reaction. Oral voriconazole was started and good glycemic control attained. Tissue growth sequences showed > 99% similarity with Fusarium solani sensu stricto. Antifungal susceptibility testing showed lowest MIC to voriconazole (0.5 mg/L). The patient showed excellent response to combined therapeutic modality with a near-complete resolution in size of lesion and obliteration of sinuses following 4 months of therapy and is planned for prolonged voriconazole therapy till complete radiological resolution. Diabetes predisposes to fungal infections of foot but eumycetomas are uncommon. Combined surgery and antifungals can improve morbidity and avoid amputations.
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Affiliation(s)
- Liza Das
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Divya Dahiya
- Department of General Surgery, PGIMER, Chandigarh, India
| | - Kirti Gupta
- Department of Histopathology, PGIMER, Chandigarh, India
| | | | - Bhanu Malhotra
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Ashu Rastogi
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Hansraj Choudhary
- Department of Medical Microbiology, PGIMER, Nehru Hospital, Research Block A, Chandigarh, India
| | | | - Pinaki Dutta
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India.
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Bhandari M, Kathuria S, Khunger N, Sharma B. Mycetoma due to Nocardia Africana/Nova Treated Successfully with Cotrimoxazole and Moxifloxacin. Indian Dermatol Online J 2021; 12:298-301. [PMID: 33959529 PMCID: PMC8088171 DOI: 10.4103/idoj.idoj_533_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/20/2020] [Accepted: 09/20/2020] [Indexed: 01/19/2023] Open
Abstract
Nocardia africana is a recently identified organism and has rarely been reported to cause mycetoma. Here we report the case of a 40-year-old woman who presented with discharging sinuses and nodules for the past 7 years along with few discrete axillary lymph nodes. Cultures and Maldi-TOF MS (Matrix-assisted laser desorption/ionization–time of flight mass spectrometry) method identified the causative organism as Nocardia africana/nova. The organism was acid-fast positive on modified Ziehl-Neelsen stain and Gram's stain revealed branched filamentous beaded gram-positive bacilli, while histopathology showed granulation tissue along with few ill-defined epithelioid cell granulomas, with giant cells. Based on the sensitivity report, the patient was started on tablet moxifloxacin and cotrimoxazole, and has shown considerable improvement at 2.5 months of follow-up.
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Affiliation(s)
- Molisha Bhandari
- Department of Dermatology and STD, Safdarjung Hospital and Vardhaman Mahavir Medical College, Ansari Nagar, New Delhi, India
| | - Sushruta Kathuria
- Department of Dermatology and STD, Safdarjung Hospital and Vardhaman Mahavir Medical College, Ansari Nagar, New Delhi, India
| | - Niti Khunger
- Department of Dermatology and STD, Safdarjung Hospital and Vardhaman Mahavir Medical College, Ansari Nagar, New Delhi, India
| | - Bhawna Sharma
- Department of Microbiology, Safdarjung Hospital and Vardhaman Mahavir Medical College, Ansari Nagar, New Delhi, India
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38
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Sharma AK, Pandey AK, Kaistha S, Ranjan KR. Abdominal wall actinomycotic mycetoma involving the bowel: a rare entity. BMJ Case Rep 2021; 14:14/1/e236948. [PMID: 33504519 PMCID: PMC7843355 DOI: 10.1136/bcr-2020-236948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Actinomycotic mycetoma is a disease of the tropical region and usually presents as a chronic, suppurative and deforming granulomatous infection. We present an unusual case of actinomycotic mycetoma of the abdominal wall that was found to infiltrate into the bowel. A 51 year-old man presented with pain and swelling in the left flank of 2-year duration. Even after comprehensive preoperative evaluation with advanced radiological imaging, biochemistry and pathology, the diagnosis could not be arrived at. Histopathological examination of the excised specimen after the surgery guided to the diagnosis of actinomycotic mycetoma, which entirely changed the management in the postoperative period. We propose that mycetoma should be kept as a possible differential diagnosis for anterior abdominal wall swelling in the indicated clinical setting and the investigations be done keeping the same in mind. Otherwise, a lot of valuable time may be lost allowing the disease to progress further.
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Affiliation(s)
- Anuj Kumar Sharma
- Department of Gastrointestinal Surgery and Liver Transplantation, Army Hospital Research and Referral, New Delhi, India
| | - Alok Kumar Pandey
- Department of Gastrointestinal Surgery and Liver Transplantation, Army Hospital Research and Referral, New Delhi, India
| | - Sumesh Kaistha
- Department of Gastrointestinal Surgery, Army Hospital Research and Referral, New Delhi, Delhi, India
| | - Kumar Rajesh Ranjan
- Department of Gastrointestinal Surgery and Liver Transplantation, Army Hospital Research and Referral, New Delhi, India
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Bouard G, Bazille C, Rochcongar G, Audoual R, Michon J, Bonhomme J. Chronic Painful Lesion. Clin Infect Dis 2021; 70:169-172. [PMID: 31840761 DOI: 10.1093/cid/ciz279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Gauthier Bouard
- Department of Anatomopathology, Normandie University, UNICAEN, University Hospital of Caen, France
| | - Céline Bazille
- Department of Anatomopathology, Normandie University, UNICAEN, University Hospital of Caen, France
| | - Goulven Rochcongar
- Department of Orthopedics and Traumatology, Normandie University, UNICAEN, University Hospital of Caen, France
| | - Régis Audoual
- Department of Radiology, Normandie University, UNICAEN, University Hospital of Caen, France
| | - Jocelyn Michon
- Department of Infectious Diseases, Normandie University, UNICAEN, University Hospital of Caen, France
| | - Julie Bonhomme
- Department of Microbiology, Normandie University, UNICAEN, University Hospital of Caen, France
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40
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Madura foot in a developed tropical country. Int J Infect Dis 2020; 101:312-313. [PMID: 33075524 PMCID: PMC7567674 DOI: 10.1016/j.ijid.2020.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 11/25/2022] Open
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Abstract
Background Mycetoma, a chronic infection of the skin and underlying structures, affects those with a close relationship to the land, often in resource-poor areas of the world. Whether caused by any one of a variety of fungus or bacteria, mycetoma causes significant disability and mortality. Acknowledged as a neglected tropical disease (NTD) by the World Health Organization (WHO) in 2016, mycetoma is susceptible to being misunderstood, misdiagnosed, and mismanaged. In an effort to shift the balance in favor of recognition and effective treatment, sound epidemiological understanding is required. Methods and findings In this paper, a literature review of case reports and series (332 papers in total) is presented as three maps. We identified 19,494 cases dating from 1876 to 2019, with cases contracted in 102 countries. The first map shows where mycetoma has ever been reported, the second shows how many cases have been reported, and the third shows the ratio of eumycetoma (fungal) to actinomycetoma (bacterial). Most cases are found in Mexico, India, and Sudan, where mycetoma is studied rigorously. We identified emergence of new geographical loci, including the United States, Venezuela, Italy, China, and Australia. Notably, mycetoma is reported far outside the tropics. In the Americas, bacterial forms dominate, whereas, in Africa and Asia, the picture is more varied. Conclusions With better understanding of the epidemiology of mycetoma, more can be done to direct education, preventive measures, and treatment to at-risk areas, enabling a reduction in disease burden. Mycetoma is an ancient and misunderstood chronic disease. Affecting the skin and subcutaneous structures, infection often occurs in the feet of land laborers and can be caused by several otherwise rare human pathogens. Traditionally seen as a tropical disease, it affects those in resource-poor regions. The best methods of diagnosis are rarely available in these areas; late diagnosis increases the need for invasive surgical treatment. Available medical treatment can be prohibitively expensive. Early diagnosis and identification of the causative agent is necessary for effective treatment. For this paper, a literature review was undertaken to find all published cases of mycetoma linked to a location and the data used to create three maps. The maps show where mycetoma has ever been reported, how many cases have been reported, and what kind of microorganism was present. We included 19,494 cases, most of which occurred in Mexico, Sudan, and India. Notably, some cases arose far outside the tropics. In the Americas, most cases are bacterial; elsewhere, the picture is more varied. Many gaps remain in the epidemiological study of mycetoma, but this paper aims to shed light on the significant reach of the disease, with a view to increasing its visibility on the global stage and, therefore, the scope for reducing the burden of this neglected tropical disease.
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Affiliation(s)
- Darcy Emery
- Manchester Medical School, University of Manchester, Manchester, United Kingdom
| | - David W. Denning
- The University of Manchester, National Aspergillosis Centre, Wythenshawe Hospital, Manchester Academic Health Science Centre, United Kingdom
- Global Action Fund for Fungal Infections, Geneva, Switzerland
- * E-mail:
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Madurella mycetomatis causing eumycetoma medical treatment: The challenges and prospects. PLoS Negl Trop Dis 2020; 14:e0008307. [PMID: 32853199 PMCID: PMC7452721 DOI: 10.1371/journal.pntd.0008307] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Bienvenu AL, Picot S. Mycetoma and Chromoblastomycosis: Perspective for Diagnosis Improvement Using Biomarkers. Molecules 2020; 25:molecules25112594. [PMID: 32498471 PMCID: PMC7321093 DOI: 10.3390/molecules25112594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Mycetoma and chromoblastomycosis are both chronic subcutaneous infectious diseases that pose an obstacle to socioeconomic development. Besides the therapeutic issue, the diagnosis of most neglected tropical diseases (NTD) is challenging. Confirmation using direct microscopy and culture, recognized as WHO essential diagnostic tests, are limited to specialized facilities. In this context, there is a need for simple user-friendly diagnostic tests to be used in endemic villages. Methods: This review discuss the available biomarkers that could help to improve the diagnostic capacity for mycetoma and chromoblastomycosis in a theoretical and practical perspective. Results: A lack of research in this area has to be deplored, mainly for mycetoma. Biomarkers based on the immune response (pattern of leucocytes, antibody detection), the dermal involvement (extracellular matrix monitoring, protein expression), and the presence of the infectious agent (protein detection) are potential candidates for the detection or follow-up of infection. Conclusion: Confirmatory diagnosis based on specific diagnostic biomarkers will be the basis for the optimal treatment of mycetoma and chromoblastomycosis. It will be part of the global management of NTDs under the umbrella of stewardship activities.
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Affiliation(s)
- Anne-Lise Bienvenu
- Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004 Lyon, France
- Service d’Hématologie, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004 Lyon, France
- Malaria Research Unit, University Lyon, ICBMS, UMR 5246 CNRS INSA CPE, Campus Lyon-Tech La Doua, F-69100 Lyon, France;
- Correspondence:
| | - Stephane Picot
- Malaria Research Unit, University Lyon, ICBMS, UMR 5246 CNRS INSA CPE, Campus Lyon-Tech La Doua, F-69100 Lyon, France;
- Groupement Hospitalier Nord, Institut de Parasitologie et Mycologie Médicale, Hospices Civils de Lyon, 69004 Lyon, France
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Nyuykonge B, Klaassen CHW, Zandijk WHA, de Hoog GS, Ahmed SA, Desnos-Ollivier M, Verbon A, Bonifaz A, van de Sande WWJ. Diagnostic implications of mycetoma derived from Madurella pseudomycetomatis isolates from Mexico. J Eur Acad Dermatol Venereol 2020; 34:1828-1834. [PMID: 32233084 PMCID: PMC7497165 DOI: 10.1111/jdv.16402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/10/2020] [Indexed: 01/21/2023]
Abstract
Background At the dermatology service of the General Hospital of Mexico City, Mexico, two patients, father and son, with black‐grain mycetoma were seen. The grains were isolated, and the cultured fungi were identified as Madurella mycetomatis based on morphology. Using the M. mycetomatis specific PCR, amplicons of a different size than that of the M. mycetomatis type strain were obtained. Objective To determine the causative agent of the two black‐grain mycetoma cases and develop non‐culture‐based diagnostic tools to identify them to the species level. Methods The M. mycetomatis specific, the internal transcribed spacer (ITS) region, β‐tubulin (BT) and ribosomal binding protein 2 (RBP2) PCRs were used to confirm the identity of the isolates. Genetic variation was established by amplification fragment length polymorphisms. To determine the antifungal susceptibility profile, the Sensititre™ YeastOne™ assay was used. To develop a species‐specific PCR primers were designed on the sequenced PCR amplicon from the M. mycetomatis specific PCR. Results By analyzing the ITS, BT and RBP2 regions the isolates were identified as Madurella pseudomycetomatis. The isolates from father and son were similar but not identical to M. pseudomycetomatis from Venezuela and one from an unknown origin. Madurella pseudomycetomatis isolates were inhibited by itraconazole, posaconazole and voriconazole but showed increased MIC values for amphotericin B and fluconazole. They were not inhibited by the echinocandins and five flucytosine. The two patients were treated with itraconazole resulting in cure for the father while the son was lost to follow‐up. The species‐specific PCR developed for M. pseudomyceotmatis was discriminative and specific. Conclusion Madurella pseudomycetomatis is genetically diverse with same susceptibility profile as M. mycetomatis and causes eumycetoma in Latin America. The M. pseudomycetomatis specific PCR can be used to identify this causative agent to the species level; however, this needs to be validated in an endemic setting.
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Affiliation(s)
- B Nyuykonge
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - C H W Klaassen
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - W H A Zandijk
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - G S de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - S A Ahmed
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - M Desnos-Ollivier
- Molecular Mycology Unit, CNRS UMR 2000, National Reference Center for Invasive Mycoses & Antifungals, Institut Pasteur, Paris, France
| | - A Verbon
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Bonifaz
- Hospital General de México Dr Eduardo Liceaga, Mexico City, Mexico
| | - W W J van de Sande
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Severe Infection and Loss of Leg Function From an Unusual Cutaneous Disease: Answer. Am J Dermatopathol 2020; 42:301-302. [PMID: 32205514 DOI: 10.1097/dad.0000000000001350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lalchandani R, Salvi BV, D’souza P, Gugnani HC. Successful Limb Salvage in a Case of Advanced Long-Standing Eumycetoma of the Foot Using Adjunctive Local Amphotericin B Delivery Through Bioabsorbable Beads. Indian J Orthop 2020; 54:224-227. [PMID: 32257041 PMCID: PMC7096342 DOI: 10.1007/s43465-019-00031-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 04/29/2019] [Indexed: 02/04/2023]
Abstract
Mycetoma is a chronic, granulomatous infection mainly involving the foot and is caused either by bacteria (actinomycetoma) or fungi (eumycetoma). Eumycetoma is notoriously resistant, posing a therapeutic challenge. There are no specific treatment guidelines but generally a combination of systemic antifungals and local surgical treatment is the accepted standard. Advanced unresponsive lesions generally require amputation. We present a case of eumycetoma of 15-year duration with extensive involvement of foot including bones. Patient had been advised amputation from various tertiary care centers but we decided to give a limb salvage trial. The patient underwent soft tissue debridement along with oral antifungal therapy. Additionally, amphotericin B-impregnated bioabsorbable beads were inserted locally into the bony cavities to supplement the treatment. There has been no recurrence till date. This case is reported in view of successful limb salvage in an advanced eumycetoma case with an unprecedented use of adjunctive local antifungal delivery.
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Affiliation(s)
- Rajesh Lalchandani
- Department of Orthopaedics, PGIMSR-ESI Hospital, Basaidarapur, New Delhi, 110015 India
| | - Bhavya V. Salvi
- Department of Orthopaedics, PGIMSR-ESI Hospital, Basaidarapur, New Delhi, 110015 India
| | - Paschal D’souza
- Department of Dermatology, PGIMSR-ESI Hospital, Basaidarapur, New Delhi, India
| | - Harish C. Gugnani
- Division of Medical Mycology, Department of Microbiology, V.P. Chest Institute, University of Delhi, Delhi, India
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Herbrík A, Corretto E, Chroňáková A, Langhansová H, Petrásková P, Hrdý J, Čihák M, Krištůfek V, Bobek J, Petříček M, Petříčková K. A Human Lung-Associated Streptomyces sp. TR1341 Produces Various Secondary Metabolites Responsible for Virulence, Cytotoxicity and Modulation of Immune Response. Front Microbiol 2020; 10:3028. [PMID: 32010093 PMCID: PMC6978741 DOI: 10.3389/fmicb.2019.03028] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/17/2019] [Indexed: 12/16/2022] Open
Abstract
Streptomycetes, typical soil dwellers, can be detected as common colonizers of human bodies, especially the skin, the respiratory tract, the guts and the genital tract using molecular techniques. However, their clinical manifestations and isolations are rare. Recently they were discussed as possible "coaches" of the human immune system in connection with certain immune disorders and cancer. This work aimed for the characterization and evaluation of genetic adaptations of a human-associated strain Streptomyces sp. TR1341. The strain was isolated from sputum of a senior male patient with a history of lung and kidney TB, recurrent respiratory infections and COPD. It manifested remarkably broad biological activities (antibacterial, antifungal, beta-hemolytic, etc.). We found that, by producing specific secondary metabolites, it is able to modulate host immune responses and the niche itself, which increase its chances for long-term survival in the human tissue. The work shows possible adaptations or predispositions of formerly soil microorganism to survive in human tissue successfully. The strain produces two structural groups of cytotoxic compounds: 28-carbon cytolytic polyenes of the filipin type and actinomycin X2. Additionally, we summarize and present data about streptomycete-related human infections known so far.
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Affiliation(s)
- Andrej Herbrík
- Institute of Immunology and Microbiology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Erika Corretto
- Institute of Soil Biology, Biology Centre Academy of Sciences of the Czech Republic, České Budějovice, Czechia
| | - Alica Chroňáková
- Institute of Soil Biology, Biology Centre Academy of Sciences of the Czech Republic, České Budějovice, Czechia
| | - Helena Langhansová
- Faculty of Science, University of South Bohemia, České Budějovice, Czechia
| | - Petra Petrásková
- Institute of Immunology and Microbiology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Jiří Hrdý
- Institute of Immunology and Microbiology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Matouš Čihák
- Institute of Immunology and Microbiology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Václav Krištůfek
- Institute of Soil Biology, Biology Centre Academy of Sciences of the Czech Republic, České Budějovice, Czechia
| | - Jan Bobek
- Institute of Immunology and Microbiology, 1st Faculty of Medicine, Charles University, Prague, Czechia.,Department of Chemistry, Faculty of Science, Jan Evangelista Purkyně University in Ústí nad Labem, Ústí nad Labem, Czechia
| | - Miroslav Petříček
- Institute of Immunology and Microbiology, 1st Faculty of Medicine, Charles University, Prague, Czechia
| | - Kateřina Petříčková
- Institute of Immunology and Microbiology, 1st Faculty of Medicine, Charles University, Prague, Czechia.,Faculty of Science, University of South Bohemia, České Budějovice, Czechia
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Gameraddin M, Gareeballah A, Mokhtar S, M Abuzaid M, Alhazmi F, Ali Hamad H. Characterization of Foot Mycetoma Using Sonography and Color Doppler Imaging. Pak J Biol Sci 2020; 23:968-972. [PMID: 32700845 DOI: 10.3923/pjbs.2020.968.972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Mycetoma of the foot, commonly referred to as Madura foot, is a chronic granulomatous infection, which impacts vascularization of the affected region. This study aimed to evaluate foot mycetoma using Doppler and sonography techniques to identify the principle sonographic features and blood flow patterns associated with the condition. MATERIALS AND METHODS This was a cross-sectional prospective single-center study conducted at the Mycetoma Research Center (MCR) in Khartoum State, Sudan. Sixty patients with Madura foot were examined using a Duplex ultrasound machine with a 7-10 MHZ linear probe. Data was analyzed using SPSS software. The distribution of demographic data was evaluated by simple descriptive statistics. Statistical tests was performed using Student's independent t-tests to compare different forms of mycetoma and Chi-square tests to examine differences in blood flow patterns between fungal (eumycetoma) and bacterial (actinomycetoma) forms of the infection. RESULTS The presence of multiple cavities and aggregated grains were more common in eumycetoma than in actinomycetoma. The echotexture was significantly more heterogeneous in eumycetoma than in actinomycetoma (p = 0.03). Eumycetoma had higher vascularity than actinomycetoma. CONCLUSION Mycetoma has characteristic sonographic features and patterns of vascularity, which are essential to differentiate between the fungal and bacterial forms of mycetoma.
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Unusual extra-podal fungal mycetoma with black grains in a Senegalese child. J Mycol Med 2019; 30:100914. [PMID: 31864802 DOI: 10.1016/j.mycmed.2019.100914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 10/18/2019] [Accepted: 11/28/2019] [Indexed: 11/21/2022]
Abstract
Mycetoma remains endemic in the tropical and subtropical regions of the "mycetoma belt" including Senegal. It affects more commonly young men in the age group of 20 to 40 years. The foot represents the most commonly affected site. The most common extra-podal localizations are leg, knee, buttocks, hand and arm. We report an exceptional case of cervical fungal mycetoma that occurred in a 13-year-old Senegalese child. He consulted for a cervico-submandibular tumefaction with multiple sinuses and black grains discharge evolving since 6 years, associated to laryngeal dyspnoea. Mycological examination with culture isolated Madurella mycetomatis. Cervical CT Scan showed bone and soft tissue invasion. Terbinafine alone was administered. During the evolution, tracheotomy was performed following the aggravation of the laryngeal disorders. Death from severe sepsis occurred after 8 months of evolution. The particularities of our case are the occurrence of fungal mycetoma in a child, the cervical localization and the difficulties of therapeutic management largely due to the diagnostic delay.
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Molinelli E, Paolinelli M, Campanati A, Brisigotti V, Offidani A. Metabolic, pharmacokinetic, and toxicological issues surrounding dapsone. Expert Opin Drug Metab Toxicol 2019; 15:367-379. [DOI: 10.1080/17425255.2019.1600670] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Matteo Paolinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Anna Campanati
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Valerio Brisigotti
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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