2018, Number 4
Dermatología Cosmética, Médica y Quirúrgica 2018; 16 (4)
Mycetoma. A Report of 174 Cases Studied in 30 Years in a General Hospital in Mexico City (1987-2017)
Cruz COF, Vega SDC, Ramírez HL, Arenas GR
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ABSTRACTBackground: mycetoma is a chronic inflammatory syndrome which depends on the inoculation of exogenous fungi or actinomycetes. In Mexico it is considered the most frequent deep mycosis. The 98% of all cases are caused by actinomycetes and only 2% by eumycetes. It is related to occupational exposure (farmers and rural workers). The most specific diagnostic method is the analysis of the grains. Treatment depends on the etiological agent. Eumycetoma is treated with antifungals and a combination with surgical procedures may be useful. Actinomycetoma respond to treatment with a broad range of antibiotics.
Objective: determine the epidemiological data of mycetoma patients in the last 30 years.
Methodology: observational, retrospective, cross-sectional, descriptive study of mycetoma patients studied at the Mycology Section of Dr Manuel Gea González General Hospital in the period between January 1987 to December 2017.
Results: data from 174 patients with mycetoma confirmed by mycologic study was obtained. Age ranged from seven to 80 years with an average age of 40 years, 71% of the cases were male, 41.38% were farmers and the most frequently affected region were lower limbs. In 4.83% was associated to type 2 diabetes mellitus. The most frequent etiological agents were Nocardia (54.48%), Actinomadura madurae (17.93%). Also eumycetes (9.66%): Madurella spp. was isolated in 2.76%, Acremonium spp. 1.38% and Pseudallescheria spp. 1.38%. Nocardia brasiliensis was identified by casein hydrolysis and molecular techniques in 15 cases.
Conclusions: a mycetoma diagnosis should be considered for patients presenting chronic granulomatose disease, fistulae and pseudonodules. Mycetoma is an important neglected disease and healthcare professionals should be trained to diagnose and treat this pathology in a timely manner.