Mycetoma
نویسندگان
چکیده
A 32-year-old woman from northeastern Brazil worked in farming and presented with a 6-year history of progressive swelling of the left foot. Swelling and sinuses draining purulent discharge with white grains ( Figure 1 ) were present. Potassium hydroxide preparation of drainage showed whiteyellowish nodules with fine filaments. Culture of the grains on Sabouraud agar and the casein hydrolysis test confirmed the presence of Nocardia brasiliensis . Hematoxylin/eosin-stained sections showed microabscesses, granulomatous reaction, and nodules containing basophilic bacterial filaments peripherally surrounded by eosinophilic pillars . The clinical diagnosis of mycetoma was thus confirmed as a bacterial mycetoma. Magnetic resonance imaging (sagittal section, post-gadolinium) showed small nodules with intensive ring enhancement distributed in the distal left leg and foot ( Figure 2 ) along with bone marrow infiltration of the calcaneus. Some spherical lesions showed hyperintense signal in the periphery and low-signal intensity central foci consistent with the recently described dot-in-circle sign. 1, 2 The patient was treated with amikacin (5 cycles with 15 mg/kg/day, for 21 days), trimethoprim sulfamethoxazole (800/160 mg, b.i.d., for 2 years), and three debridement procedures resulting in a satisfactory clinical response. Magnetic resonance imaging may be useful for the early diagnosis of mycetoma. Delayed diagnosis of this condition is
منابع مشابه
Actinomycotic Mycetoma: Report of 4 cases from Khuzestan province
Mycetoma is a chronic, progressive, and destructive disease primarily caused by actinomycetes. This is a report of 4 cases of actinomycotic mycetomas studied in our hospital during the last five years. The patients included 2 men, 56 and 42 years old, and 2 women, 31 and 52 years old, from Khuzestan province located in the south west of Iran. Clinically all patients presented with mycetoma synd...
متن کاملMycetoma Maduromycosis Madura Foot Mycetoma is a chronic localized infection caused by different species of fungi or actinomycetes
متن کامل
Mycetoma laboratory diagnosis: Review article
Mycetoma is a unique neglected tropical disease caused by a substantial number of microorganisms of fungal or bacterial origins. Identification of the causative organism and the disease extension are the first steps in the management of the affected patients and predicting disease treatment outcome and prognosis. Different laboratory-based diagnostic tools and techniques were developed over the...
متن کاملMapping the Potential Risk of Mycetoma Infection in Sudan and South Sudan Using Ecological Niche Modeling
In 2013, the World Health Organization (WHO) recognized mycetoma as one of the neglected tropical conditions due to the efforts of the mycetoma consortium. This same consortium formulated knowledge gaps that require further research. One of these gaps was that very few data are available on the epidemiology and transmission cycle of the causative agents. Previous work suggested a soil-borne or ...
متن کاملThe dot-in-circle sign of mycetoma on MRI.
Mycetoma is a chronic granulomatous disease prevalent in tropical countries, but it also occurs in Europe and the United States. Early diagnosis is important as it has therapeutic implications. Although biopsy and microbiological culture provide the definitive diagnosis, these are difficult to achieve in many instances. The dot-in-circle sign is a recently proposed magnetic resonance imaging (M...
متن کامل