title: Internal fistula formation: an unusual complication of mycetoma.
abstract: This paper reports 2 hitherto undescribed complications of mycetoma, urinary extravasation and expectoration of mycetoma grains due to cutaneo-urethral and cutaneo-pleuro-bronchial fistulae, respectively. The first patient had an infection with Actinomadura madurae which started in the foot and had spread progressively to involve the whole limb, anterior abdominal wall, perineum and urethra. The second patient had Madurella mycetomatis infection of the hand and, in spite of extensive treatment, the infection had spread to the axilla, chest wall, lung and bronchial tree. Both patients died of the sequelae of these complications. The pathogenesis of these unusual complications is discussed.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan.
authors.forename: A H
authors.initials: AH
authors.lastname: Fahal
authors.forename: A R
authors.initials: AR
authors.lastname: Sharfi
authors.forename: H E
authors.initials: HE
authors.lastname: Sheik
authors.forename: A M
authors.initials: AM
authors.lastname: el Hassan
authors.forename: E S
authors.initials: ES
authors.lastname: Mahgoub
mesh_terms: D000328:Adult; D000672:Amputation Stumps; D001983:Bronchial Fistula / Q000382:microbiology*; D017577:Cutaneous Fistula / Q000382:microbiology*; D017809:Fatal Outcome; D005402:Fistula / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000302:isolation & purification; D008271:Mycetoma / Q000150:complications*; D010995:Pleural Diseases / Q000382:microbiology*; D011183:Postoperative Complications; D014522:Urethral Diseases / Q000382:microbiology*; D014548:Urinary Fistula / Q000382:microbiology*