Mycetoma
From IDWiki
- Chronic progressive granulomatous infection of the skin and subcutaneous tissue, usually affecting a single extremity
Background
Microbiology
- Can be caused either by fungi or filamentous aerobic bacteria
- Fungal species (eumycotic mycetoma):
- Dark grains:
- Pale/white grains:
- Pseudallescheria boydii (most common) (Scedosporium)
- Acremonium kiliense
- Aspergillus flavus, Aspergillus nidulans, Aspergillus hollandicus
- Aerobic bacteria (actinomycotic mycetoma):
- Nocardia brasiliensis
- Actinomadura madurae
- Streptomyces somaliensis
- Actinomadura pelletieri (grains are red to pink)
Clinical Presentation
- Clinical triad:
- Localized swelling
- Underlying sinus tract
- Grains and granules (“sulfur granules”) within the sinus tracts
Diagnosis
- Send granules in sterile container
- Gram stain a crushed granule for bacteria, then set up cultures for bacterial and fungal cultures