II. Definitions
- Mycetoma (Maduramycosis)
- Chronic progressive subcutaneous, Granulomatous infection
- Caused by non-acid fast Bacteria (Actinomycetoma) and fungi (Eumycetoma)
- Subcutaneous Nodules, abscesses, fistulae and swelling, typically on legs, and may involve hands
- Complications include local disfiguring lesions, and if untreated, Osteomyelitis or ankylosis
- Rare, life threatening systemic spread to Pelvis, lungs, spinal cord
- Actinomycetoma
- Chronic subcutaneous, Granulomatous lesions due to Actinomycetes, non-acid fast Bacteria
- Actinomycetes include soil-based Bacteria, Actinomadura, Nocardia, Streptomyces
- Eumycetoma
- Chronic subcutaneous, Granulomatous lesions due to fungal infection
III. Causes: Nodular Lymphangitis
- Common Causes
- Sporotrichosis: Sporothrix schenckii (fungus)
- Classic prototype of 'sporotrichoid' infection
- Gardening, splinters or Animal Bites or scratches
- Nocardia brasiliensis (Nocardiosis)
- Gardening or splinter exposure
- Mycobacterium marinum
- Aquariums, fish handling or other water exposure
- Leishmania brasiliensis (Leishmaniasis)
- Limited to sandfly endemic areas
- Sporotrichosis: Sporothrix schenckii (fungus)
- Other Causes
- Nocardia asteroides
- Atypical Mycobacteria
- Francisella tularensis
- Blastomyces dermatidis
- Coccidioides immitis
- Cryptococcus neoformans
- Histoplasma capsulatum
- Streptococcus Pyogenes
- Staphylococcus aureus
- Pseudomonas pseudomallei
- Bacillus anthracis (Anthrax)
- CowpoxVirus
IV. Findings: Nodular Lymphangitis
- Exposure to soil or water borne organisms
-
Granulomatous reaction up extremity lymph chain
- Nodular lesions
- Local tissue necrosis
- Abscess formation
- No systemic symptoms
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)
- Cellulitis with ascending lymphangitis
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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 |
