title: Mycetoma: a unique neglected tropical disease.
abstract: 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. 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.
authors.affiliation: Rotterdam Centre for Tropical Medicine, Rotterdam, Netherlands. Electronic address: e.e.zijlstra@roctm.com.
authors.forename: Eduard E
authors.initials: EE
authors.lastname: Zijlstra
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University of Rotterdam, Rotterdam, Netherlands.
authors.forename: Wendy W J
authors.initials: WWJ
authors.lastname: van de Sande
authors.affiliation: University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
authors.forename: Oliverio
authors.initials: O
authors.lastname: Welsh
authors.affiliation: Mycetoma Research Center, University of Khartoum, Khartoum, Sudan.
authors.forename: El Sheikh
authors.initials: ES
authors.lastname: Mahgoub
authors.affiliation: University of Newcastle, Newcastle upon Tyne, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Goodfellow
authors.affiliation: Mycetoma Research Center, University of Khartoum, Khartoum, Sudan.
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Fahal
mesh_terms: D039903:Actinobacteria; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D006801:Humans; D020461:Madurella; D008271:Mycetoma / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D058069:Neglected Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents