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[Cranial and cervical vertebral mycetoma. Report of three cases]
1Service de Neurochirurgie, Centre Hospitalier National de Fann-Dakar, Dakar, Sénégal.
Abstract:
Mycetomas inflammatory-like tumors presenting as fistulas found in the skin and soft tissues. Inoculation, generally in tropical areas, occurs by skin injury. The foot is the main infection site. Other uncommon infection sites include the cranial and cervical areas which are rare. We present three cases of cranial and cervical mycetoma. Clinical sign were dominated by headache, cervical pain and cervico-occipital tumefaction with formation of pus and granules (red in two cases, black in one). A motor deficit was noted in one patient. Radiographic examinations including CT scan showed extensive mass lesions, associated with bone destruction. Laboratory tests identified Leptospheria senegalensis in one patient and Actinomadura pelletieri in two. A medicosurgical procedure was performed. The course was unfavourable in one patient. Several factors are important for treating such infections: early diagnosis, improvement of the social and economic environment, use of new drugs.
Insights
Cranial and cervical mycetomas are rare fungal or bacterial infections presenting as painful tumors. Early diagnosis and treatment are crucial for managing these debilitating conditions.
Area of Science:
- Medical Mycology
- Infectious Diseases
Background:
- Mycetomas are inflammatory tumors caused by fungal or bacterial pathogens, typically inoculated via skin injury in tropical regions.
- While commonly affecting the foot, mycetomas can rarely occur in the cranial and cervical areas.
Observation:
- This study presents three cases of cranial and cervical mycetoma.
- Clinical signs included headache, cervical pain, cervico-occipital tumefaction with pus and granules, and motor deficit in one case.
- Radiographic examinations revealed extensive mass lesions with bone destruction.
Findings:
- Laboratory tests identified Leptospheria senegalensis in one case and Actinomadura pelletieri in two cases.
- Medicosurgical intervention was performed, with an unfavorable outcome in one patient.
Implications:
- Cranial and cervical mycetomas require early diagnosis and a comprehensive treatment approach.
- Improving socioeconomic conditions and utilizing novel therapeutic agents are vital for managing these rare infections.
