[Mycetomas originated from South-East Bulgaria (author's transl)]

According to investigations by the author, Bulgaria occupies a major position by the number of mycomas in European countries with temperate climate and small area. From 18 cases of mycomas, 10 cases, whom 7 were maduromycetomas or eumycetomas, originated from South-East Bulgaria, near Black Sea and Asia Minor, with warm and dry climate. This confirms that the climate has a definite influence on the disease. 6 maduromycetomas with black granules were caused by Madurella mycetomi and the only white granules mycetoma was caused by Monosporium apiospermum. Actinomycetomas were caused by Nocardia species and Actinomadura madurae. Despite the favorable effect of antibacterial compound (with special reference to Nibiol/Nitroxoline), in vitro, the actinomycetomas are more resistant to the therapy and they show a more rapid evolution. It is necessary to make a quick and early diagnosis to avoid an invasion of the underlying bones and the necessity of an amputation.