II. Definitions
- Mycetoma (Maduramycosis)
- Actinomycetoma
- Chronic subcutaneous, Granulomatous lesions due to Actinomycetes, non-acid fast Bacteria
- Actinomycetes include soil-based Bacteria, Actinomadura, Nocardia, Streptomyces
- Growth is more aggressive than Eumycetoma
- Eumycetoma
- Chronic subcutaneous, Granulomatous lesions due to fungal infection
III. Epidemiology
- Actinomycetoma
- Most cases found in Mexico and Venezuela (sporadic cases in United States and Europe)
- Eumycetoma
- Most cases found in Sudan, Senegal, Nigeria, Somalia, Mauritania, and India
IV. Findings
- Subcutaneous Lesions
- Nodules
- Skin Abscesses
- Skin fistulae
- Localized swelling
- Distribution
- Typically on legs
- May involve hands
V. Labs: Histology
- Mycetoma
- Suppurative Granulomas
- Neutrophil infiltrates
- Palisaded histiocytes
- Actinomycetoma
- Thin filaments (0.5 to 1 um) on Gram Stain or methenamine silver stain
- Eumycetoma
- Thick fungal hyphae
VI. Differential Diagnosis
- See Subcutaneous Nodule (e.g. Rheumatoid Nodule)
- Nodular Lymphangitis
- Cellulitis with ascending lymphangitis
VII. Management
- Surgical debulking may be attempted but high recurrence rate
- Actinomycetoma
- Dapsone
- Streptomycin
- Trimethoprim-Sulfamethoxazole
- Amikacin
- Rifampin
- Amoxicillin-clavulanic acid
- Eumycetoma
- Systemic Antifungals specific to organism
VIII. Complications
- Local disfiguring lesions
- Osteomyelitis or ankylosis (if untreated)
- Systemic spread to Pelvis, lungs, spinal cord (rare, high mortality)
IX. References
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Related Studies
Definition (MSH) | A chronic progressive subcutaneous infection caused by species of fungi (eumycetoma), or actinomycetes (actinomycetoma). It is characterized by tumefaction, abscesses, and tumor-like granules representing microcolonies of pathogens, such as MADURELLA fungi and bacteria ACTINOMYCETES, with different grain colors. |
Definition (NCI) | A chronic granulomatous inflammation involving the deep dermis and the subcutaneous tissues. It is caused by fungi and actinomycetes. |
Concepts | Disease or Syndrome (T047) |
MSH | D008271 |
ICD10 | B47 , B47.9 |
SnomedCT | 187497002, 410039003 |
English | Mycetomas, Mycetoma, unspecified, [X]Mycetoma, unspecified, mycetoma (diagnosis), mycetoma, Mycetoma, Mycetoma NOS, Mycetoma [Disease/Finding], madura foot, fungal mycetoma, maduramycosis, mycetomas, maduromycosis, [X]Mycetoma, unspecified (disorder), Mycetoma (disorder), Mycetomata |
Dutch | mycetoom NAO, Mycetoom, niet gespecificeerd, Mycetoom |
French | Mycétome SAI, Mycétome |
German | Myzetom NNB, Myzetom, nicht naeher bezeichnet, Myzetom, Mycetom |
Italian | Micetoma non specificato, Micetoma |
Portuguese | Micetoma NE, Micetoma |
Spanish | Micetoma NEOM, Micetoma, [X]micetoma, no especificado (trastorno), [X]micetoma, no especificado, micetoma, micetoma (trastorno) |
Japanese | 足菌腫NOS, アシキンシュNOS, ソクキンシュNOS, 菌腫, マズラミコーシス, マズラ菌症, マズラ足, 真菌性マズラ菌症, 足菌腫, 足菌腫症, マズラ足(マズラアシ) |
Swedish | Madurafot |
Finnish | Maduromykoosi |
Russian | MITSETOMA, MADUROMIKOZ, STOPA MADURSKAIA, СТОПА МАДУРСКАЯ, МИЦЕТОМА, МАДУРОМИКОЗ |
Czech | Mycetom NOS, mycetom |
Korean | 상세불명의 균종, 균종 |
Croatian | MICETOM |
Polish | Stopa madurska, Mycetoma, Aktynomycetoma, Maduromikoza, Grzybica madurska, Stopa madurska grzybicza |
Hungarian | Mycetoma k.m.n. |
Norwegian | Mycetom |
Ontology: Actinomycetoma (C1261283)
Definition (NCI) | A chronic granulomatous inflammation involving the deep dermis and the subcutaneous tissues. It is caused by Actinomycetes bacteria. |
Concepts | Disease or Syndrome (T047) |
MSH | D008271 |
ICD10 | B47.1 |
SnomedCT | 186397005, 37431000, 82684004, 187089001 |
Dutch | actinomycetomen, actinomycose; mycetoom, actinomycotisch; mycetoom, infectie; mycetoom, actinomycotisch, mycetoom; actinomycose, mycetoom; actinomycotisch, mycetoom; infectie, actinomycotisch, mycetoom; voet, actinomycotisch, voet; mycetoom, actinomycotisch, Actinomycetoom |
German | Aktinomycetome, Aktinomyzetom, Aktinomyzetoma |
Italian | Actinomicetomi, Actinomicetoma |
Portuguese | Actinomicetomas |
Spanish | Actinomicetomas, micetoma actinomicótico del pie, esquizomicetoma actinomicótico, micetoma actinomicótico, pie de Madura por Actinomadura, pie de Madura actinomicótico (trastorno), pie de Madura actinomicótico, pie de Madura por Actinomadura (trastorno), maduromicosis actinomicótica, actinomicetoma (trastorno), actinomicetoma, maduromicosis - actinomicótico (trastorno), maduromicosis - actinomicótico, pie de Madura por Actinomadura (concepto no activo) |
Japanese | 放線菌腫, ホウセンキンシュ |
English | Madura foot - actinomycotic, Actinomycetoma, Actinomycetomas, actinomycetoma (diagnosis), Madura foot due to Actinomadura (disorder), Actinomycotic madura foot (disorder), Actinomycotic schizomycetoma, Actinomycotic maduromycosis, Madura foot due to Actinomadura, Actinomycotic mycetoma, Actinomycotic mycetema, Actinomycotic mycetoma (disorder), Madura foot - actinomycotic (disorder), actinomycetoma, foot; mycetoma, actinomycotic, infection; mycetoma, actinomycotic, actinomycosis; mycetoma, actinomycotic; mycetoma, mycetoma; actinomycosis, mycetoma; actinomycotic, mycetoma; foot, actinomycotic, mycetoma; infection, actinomycotic, Madura foot due to Actinomadura, NOS, Actinomycotic madura foot, Actinomycotic mycetoma of foot |
Czech | Actinomycetomy, aktinomycetom |
French | Actinomycétome |
Korean | 방선균종 |
Hungarian | actinomycetomák |
Norwegian | Aktinomycetom |
Ontology: Eumycetoma (C2350621)
Concepts | Disease or Syndrome (T047) |
MSH | D008271 |
ICD9 | 117.4 |
ICD10 | B47.0 |
SnomedCT | 29761005, 187088009, 410038006 |
English | Madura foot - mycotic, eumycotic mycetoma (diagnosis), eumycotic mycetoma, Eumycetomas, Mycetoma mycotic, Eumycetoma, Madura foot, mycotic, Maduromycosis, Mycotic mycetoma (disorder), eumycetoma, eumycotic; mycetoma, infection; mycetoma, mycotic, mycetoma; eumycotic, mycetoma; infection, mycotic, mycetoma; mycotic, mycotic; mycetoma, Mycotic mycetoma, Eumycotic mycetoma, Fungal mycetoma, Eumycotic mycetoma (disorder), Mycotic mycetomas |
Italian | Micetoma micotico, Micetomi micotici, Eumicetoma |
Dutch | mycotische mycetomen, eumycotisch; mycetoom, infectie; mycetoom, mycotisch, mycetoom; eumycotisch, mycetoom; infectie, mycotisch, mycetoom; mycotisch, mycotisch; mycetoom, Eumycetoom, mycetoom mycotisch |
French | Mycétomes mycosiques, Eumycétome, Mycétome mycotique |
German | mykotische Myzetome, Eumyzetom, Eumyzetoma, Eumycetom, mykotisches Myzetom |
Portuguese | Micetomas micóticos, Micetoma micótico |
Spanish | Micetomas micóticos, micetoma micótico, eumicetoma, micetoma micótico (trastorno), Micetoma micótico, micetoma eumicótico, micetoma eumicótico (trastorno) |
Japanese | 真菌性足菌腫, シンキンセイソクキンシュ |
Czech | Mykotický mycetom, Mykotické mycetomy, eumycetom |
Korean | 진균종 |
Hungarian | Mycoticus mycetomák, mycotikus mycetoma |
Norwegian | Eumycetom |