Mycetoma in Saudi Arabia.

Area of Science:

• Medical Mycology
• Infectious Diseases
• Clinical Microbiology

Background:

• Mycetoma is a chronic, granulomatous infectious disease affecting subcutaneous tissue, bone, and muscle.
• It is endemic in tropical and subtropical regions, often caused by fungi or aerobic actinomycetes.
• Understanding the etiological agents and clinical presentation is crucial for effective management.

Purpose of the Study:

• To describe the clinical and microbiological features of mycetoma cases.
• To identify the causative agents of mycetoma in Riyadh, Saudi Arabia.
• To analyze treatment outcomes and geographical distribution of different mycetoma types.

Main Methods:

• Retrospective review of 31 mycetoma cases over 8 years.
• Clinical data collection including patient demographics, lesion characteristics, and treatment history.
• Microbiological identification of causative agents through laboratory analysis.

Main Results:

• Thirty-one cases of mycetoma were analyzed, with 18 caused by Streptomyces somaliensis and 10 by Madurella mycetomatis.
• Other identified agents included Actinomadura madurae, Nocardia asteroides, and an unidentified Cladosporium species.
• Eleven patients presented with osteolytic lesions, 17 required surgical intervention, and only seven achieved a complete cure.

Conclusions:

• Streptomyces somaliensis and Madurella mycetomatis are the predominant mycetoma pathogens in Riyadh.
• Mycetoma infections showed distinct geographical patterns, with Streptomyces prevalent across Saudi Arabia and Madurella concentrated in highland regions.
• The study highlights the challenges in treating mycetoma, often necessitating surgery and resulting in suboptimal cure rates.