[Mycetoma and their treatment]

Area of Science:

• Medical Mycology
• Infectious Diseases
• Dermatology

Background:

• Mycetoma are chronic subcutaneous infections endemic in tropical regions, often affecting the foot.
• Caused by fungi (eumycetoma) or actinomycetes (actinomycetoma), they present as filamentous grains.
• Delayed diagnosis leads to advanced, mutilating lesions, particularly involving bone.

Purpose of the Study:

• To highlight the importance of early detection in mycetoma management.
• To differentiate between actinomycetoma and eumycetoma based on diagnostic and therapeutic approaches.
• To review current and potential treatment strategies for both forms of mycetoma.

Main Methods:

• Clinical presentation analysis of mycetoma cases.
• Review of diagnostic methods for differentiating fungal and bacterial causes.
• Evaluation of therapeutic outcomes for actinomycetoma and eumycetoma.

Main Results:

• Clinical presentations of actinomycetoma and eumycetoma are similar, necessitating biological diagnosis.
• Actinomycetoma treatment involves trimethoprim-sulphamethoxazole (STX), sometimes with amikacin, with rare surgical intervention.
• Eumycetoma shows disappointing results with antifungals alone, requiring combined medical and surgical treatment; itraconazole is commonly used.

Conclusions:

• Early detection and accurate etiological diagnosis are critical for successful mycetoma treatment.
• Distinct therapeutic strategies are required for actinomycetoma (antibiotics) and eumycetoma (surgery plus antifungals).
• Further evaluation of novel antifungal agents is needed for eumycetoma management.