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Mycetoma sans sinuses.

Sudipta Saha1, Anita Dhar, A K Karak

  • 1Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Indian Journal of Dermatology, Venereology and Leprology
|May 19, 2006
PubMed
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Mycetoma is a chronic fungal or bacterial infection. This case highlights a rare presentation of mycetoma without draining sinuses, posing a diagnostic challenge for clinicians.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Dermatology

Background:

  • Mycetoma is a neglected tropical disease characterized by a triad of features: tumefaction, draining sinuses, and grain formation.
  • It is a chronic suppurative infection affecting the skin, subcutaneous tissue, and underlying bone.
  • Sinus tract development is a common and early clinical manifestation in most mycetoma cases.

Observation:

  • A patient presented with a 9-year history of a mycetoma lesion.
  • The lesion exhibited tumefaction and grain formation, consistent with mycetoma.
  • Notably, the patient had no draining sinuses, which is atypical for mycetoma.

Findings:

  • The absence of draining sinuses for an extended period (9 years) presented a significant diagnostic dilemma.

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  • This atypical presentation challenges the classical diagnostic criteria for mycetoma.
  • Microscopic examination of the grains confirmed the presence of fungal elements, supporting the mycetoma diagnosis despite the lack of sinuses.

    • Implications:

    • This case underscores the importance of considering mycetoma even in the absence of typical sinus tracts.
    • It highlights the need for a broader differential diagnosis in chronic subcutaneous infections.
    • Further research into atypical mycetoma presentations is warranted to improve diagnostic accuracy and patient outcomes.