Mycetomas in northern Yemen: identification of causative organisms and epidemiologic considerations

Fifteen cases of mycetomas from four locations in northern Yemen were studied. On the basis of morphologic characteristics and staining properties of the granules in discharges from the draining sinus tracts (a narrow elongated cavity that extends from a focus of suppuration or other inflammatory softening to a free surface and through which pus discharges) in the affected appendages and in tissue sections, three causative organisms were identified: Streptomyces somaliensis, Actinomadura madurae, and Madurella mycetomatis. Because of the similarity in the climate and the causative organisms, northern Yemen can be considered as being in the same endemic area for mycetomas as eastern Africa.