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Evaluating the Function of the Foot Core System in the Elderly

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The madura foot: looking deep.

Sandhya Venkatswami¹, Anandan Sankarasubramanian, Shobana Subramanyam

¹Sri Ramachandra University, Chennai, India. sandhyavenkatswami@yahoo.com

The International Journal of Lower Extremity Wounds

|February 16, 2012

Summary

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Mycetoma, a chronic infection caused by fungi or bacteria, presents with swelling, abscesses, and colored grains. Early diagnosis and treatment are crucial, as actinomycetoma can spread rapidly, while eumycetoma requires surgery and antifungals.

Area of Science:

Medical Mycology
Infectious Diseases
Dermatology

Background:

Mycetoma is a chronic subcutaneous infection caused by fungi (eumycetoma) or bacteria (actinomycetoma).
It commonly affects the foot due to minor trauma in barefoot populations, predominantly adult males.
The disease is characterized by tumefaction, abscess fistulization, and extrusion of colored grains.

Purpose of the Study:

To provide a comprehensive overview of mycetoma, covering its etiology, clinical presentation, diagnostic methods, and therapeutic challenges.
To differentiate between actinomycetoma and eumycetoma regarding their clinical course and treatment responses.

Main Methods:

Review of existing literature on mycetoma.
Analysis of diagnostic tools including radiology, ultrasonology, cytology, histology, immunodiagnosis, culture, and DNA sequencing.

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Comparison of treatment strategies for actinomycetoma and eumycetoma.

Main Results:

Mycetoma diagnosis relies on clinical triad and various investigations, with grain color offering diagnostic clues.
Actinomycetoma has a rapid course and higher risk of systemic spread and mortality compared to eumycetoma.
Actinomycetomas respond better to antibiotics, while eumycetomas necessitate surgical intervention alongside antifungal therapy.

Conclusions:

Mycetoma poses a significant therapeutic challenge due to its chronic nature and potential for disfigurement.
Accurate differentiation between fungal and bacterial causes is essential for effective treatment, balancing antibiotics, antifungals, and surgery.
Prompt diagnosis and management are critical to prevent severe complications like sepsis and limb amputation.