Surgical treatment of fungal mycetoma

Chemotherapy for chronic fungal infections is often ineffective, and the associated delay in surgical treatment may result in radical procedures being performed to effect a cure. The author describes four patients with chronic fungal lesions, three involving a foot and one the abdominal wall, all of which failed to respond to antifungal chemotherapy. The lesions were excised, using procedures aimed at preserving function. Infection recurred in two patients during a 9-month follow-up. The author concludes that surgical therapy should be instituted early in the disease to forestall spread to deeper structures and preserve functional integrity of the affected parts.