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Mycetoma: a unique neglected tropical disease

Lookup NU author(s): Professor Michael Goodfellow


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Mycetoma can be caused by bacteria (actinomycetoma) or fungi (eumycetoma) and typically affects poor communities in remote areas. It is an infection of subcutaneous tissues resulting in mass and sinus formation and a discharge that contains grains. The lesion is usually on the foot but all parts of the body can be affected. The causative microorganisms probably enter the body by a thorn prick or other lesions of the skin. Mycetoma has a worldwide distribution but is restricted to specific climate zones. Microbiological diagnosis and characterisation of the exact organism causing mycetoma is difficult; no reliable serological test exists but molecular techniques to identify relevant antigens have shown promise. Actinomycetoma is treated with courses of antibiotics, which usually include co-trimoxazole and amikacin. Eumycetoma has no acceptable treatment at present; antifungals such as ketoconazole and itraconazole have been used but are unable to eradicate the fungus, need to be given for long periods, and are expensive. Amputations and recurrences in patients with eumycetoma are common.

Publication metadata

Author(s): Zijlstra EE, van de Sande WWJ, Welsh O, Mahgoub ES, Goodfellow M, Fahal AH

Publication type: Review

Publication status: Published

Journal: Lancet Infectious Diseases

Year: 2016

Volume: 16

Issue: 1

Pages: 100-112

Print publication date: 01/01/2016

Online publication date: 15/12/2015

Acceptance date: 01/01/1900

ISSN (print): 1473-3099

ISSN (electronic): 1474-4457



DOI: 10.1016/S1473-3099(15)00359-X