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Infectious disease

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Mycetoma pathogens

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Pathogenesis

Epidemiology
Diagnostics
Treatment

Miketoma (maduromycosis, Malurian foot) - chronic purulent-inflammatory process of subcutaneous tissue and adjacent tissues. Mycetoma originators are demacic fungi (eumycotic mycetoma) or actinomycetes (actin and cetoma) of the genera Actinomyces, Nocardia, Sireptomyces, Actimomadura. Among the fungi are Pseudallescheria boydii, Aeremomum (Cephalosporium) Jidciforme, Madurella grisea, Phialophora cryanescem, Exophiala jrcmselmei, Scedosporium apiospermum, Leptosphaeria senegcdensis.

trusted-source [1], [2], [3], [4], [5], [6], [7]

Pathogenesis and symptoms of mycetoma

Infection occurs through damaged skin. Gradually formed papules, deep nodes and abscesses. The destructive process affects the fascia, muscles and bones. Fibrinous tissue develops. Most often affected are the lower limbs. The foot swells and deforms.

Epidemiology of mycetoma

Mycetoma pathogens live in the soil and on plants. They are transmitted by contact. An aerogenic transmission with respiratory tract damage is also possible. Miketoma is more common in the tropics and subtropics.

trusted-source [8], [9], [10], [11],

Microbiological diagnosis of mycetoma

In pus, bioptate, treated with KOH solution, characteristic colored grains (diameter 0.5-2 microns), septate hyphae and chlamydospores of fungi are revealed. The hyphae of Pseudallescheria boydii are difficult to distinguish from Aspergillus. In the presence of actinomycetes, druses and branching thin bacterial filaments are seen. The sexual stage of P. Boydii is accompanied by the formation of cleistothecia (100-200 μm), which breaks and releases pale brown elliptical ascospores.

Treatment of mycetoma

Miketoma is treated with itraconazole. Possible resection of the affected tissue.