Epidemiology of Mycetoma in Patients Referred to the Medical Mycology Laboratory,Kerman

Objective Of The Study: 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(1). 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. The authors had for objective to present the case of mycetomas diagnosed in developed country and their management(2). Patient And Methods : A retrospective study was made on the clinical presentation and management of mycetomas from 2008 to 2018, in kerman and its suburb. Results: seven patient files were studied. The patients were male with a median age 45 of (20-60) years. The etiologies were six actinomycetoma and one eumycetomas. There was bone involvement in all cases. Also all cases were involvement foot lesion .seven patients were cured including one by surgical managementand which had ampotated one toe clashes and six by medical treatment (actinomycetoma). Antifungal therapy failed (one patient) in every case (voriconazole, itraconazole, ketoconazole, terbinafine, caspofungin, trimethoprim-sulfamethoxazole (TMP-SMZ), dapsone (diaminodiphenylsulfone), and streptomycin sulfate. Amikacin and imipenem ). Conclusion: The results of this study shows that Myastoma cases are not limited to this, and attention should be paid to preventing and informing people about fungal infections.also we need to be careful about eumycetoma , which results in amputation.

Keywords:

Actinomycetoma , Eumycetoma , , kerman , Mycetoma