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The Israel Medical Association Journal... Jul 2015Mycetoma is a chronic and destructive infection caused by either fungus or bacteria. Mycetoma has a characteristic clinical presentation of a triad of tumor-like...
BACKGROUND
Mycetoma is a chronic and destructive infection caused by either fungus or bacteria. Mycetoma has a characteristic clinical presentation of a triad of tumor-like swelling, draining sinuses, and macroscopic grains. Mycetoma infection is extremely rare in Israel; however, in view of the recent immigration from mycetoma-hyperendemic regions of Africa to Israel, physicians in Israel may encounter this infection.
OBJECTIVES
To present two cases of mycetoma caused by Madurella mycatomatis in immigrants from endemic regions in Sudan treated at our hospital, and review the current literature.
CONCLUSIONS
Health care professionals in Israel should suspect mycetoma in patients from endemic countries who present with tumor-like swelling especially in the lower extremity. Health care workers should be able to recognize mycetoma and provide the optimal treatment before the lesion progresses to an advanced and disabling disease.
Topics: Adult; Emigrants and Immigrants; Foot Diseases; Humans; Israel; Madurella; Male; Mycetoma; Sudan; Young Adult
PubMed: 26357716
DOI: No ID Found -
Journal of Clinical Microbiology Mar 2012A new species of nonsporulating fungus, isolated in a case of black-grain mycetoma in Sudan, is described as Madurella fahalii. The species is characterized by...
A new species of nonsporulating fungus, isolated in a case of black-grain mycetoma in Sudan, is described as Madurella fahalii. The species is characterized by phenotypic and molecular criteria. Multigene phylogenies based on the ribosomal DNA (rDNA) internal transcribed spacer (ITS), the partial β-tubulin gene (BT2), and the RNA polymerase II subunit 2 gene (RPB2) indicate that M. fahalii is closely related to Madurella mycetomatis and M. pseudomycetomatis; the latter name is validated according to the rules of botanical nomenclature. Madurella ikedae was found to be synonymous with M. mycetomatis. An isolate from Indonesia was found to be different from all known species based on multilocus analysis and is described as Madurella tropicana. Madurella is nested within the order Sordariales, with Chaetomium as its nearest neighbor. Madurella fahalii has a relatively low optimum growth temperature (30°C) and is less susceptible to the azoles than other Madurella species, with voriconazole and posaconazole MICs of 1 μg/ml, a ketoconazole MIC of 2 μg/ml, and an itraconazole MIC of >16 μg/ml. Since eumycetoma is still treated only with azoles, correct species identification is important for the optimal choice of antifungal therapy.
Topics: Antifungal Agents; DNA, Fungal; DNA, Ribosomal Spacer; Fungal Proteins; Humans; Leg; Madurella; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Sequence Data; Mycetoma; Phylogeny; Pyrimidines; RNA Polymerase II; Sequence Analysis, DNA; Sudan; Triazoles; Tubulin; Voriconazole
PubMed: 22205798
DOI: 10.1128/JCM.05477-11 -
Journal of Neurosurgery. Pediatrics Jul 2012Craniocerebral maduromycetoma is extremely rare; only 2 cases have been reported so far. The authors report a case of maduromycetoma in a 17-year-old girl from a rural...
Craniocerebral maduromycetoma is extremely rare; only 2 cases have been reported so far. The authors report a case of maduromycetoma in a 17-year-old girl from a rural background in the state of Rajasthan, India, with involvement of the right parietal cortex, overlying bone, and subcutaneous tissue. The mass was totally excised, along with the involved dura mater, bone, and scalp. She was given antifungal drugs in the postoperative period. The patient responded very well to the treatment, and there were no signs of recurrence at the 6-month follow-up visit. The clinical features, imaging and histopathological investigations, and management of this rare entity are discussed, and the available literature is reviewed.
Topics: Adolescent; Antifungal Agents; Bone Diseases; Brain Diseases; Female; Humans; India; Madurella; Magnetic Resonance Imaging; Mycetoma; Naphthalenes; Parietal Lobe; Pyrimidines; Scalp; Seizures; Terbinafine; Tomography, X-Ray Computed; Triazoles; Voriconazole
PubMed: 22702332
DOI: 10.3171/2012.3.PEDS1252 -
Frontiers in Pharmacology 2023Eumycetoma, a chronic subcutaneous mycosis, responds poorly to the available antifungal treatments and patients often require extensive surgical resection or amputation... (Review)
Review
Eumycetoma, a chronic subcutaneous mycosis, responds poorly to the available antifungal treatments and patients often require extensive surgical resection or amputation of the affected limb. More effective treatments are needed for eumycetoma. This article will describe some of the approaches being used to develop and evaluate new treatments for eumycetoma, summarise the latest developments and discuss the challenges that lie ahead.
PubMed: 37274106
DOI: 10.3389/fphar.2023.1165273 -
International Journal of Dermatology Aug 2009Eumycetoma is a chronic granulomatous infection of the skin, subcutaneous tissue, fascia, and bone caused by true fungi. Most commonly, it affects the foot or hand....
Eumycetoma is a chronic granulomatous infection of the skin, subcutaneous tissue, fascia, and bone caused by true fungi. Most commonly, it affects the foot or hand. Fungi commonly reported to cause eumycetoma are Madurella mycetomatis, Madurella grisea, Phialophora jeanselmei, Cephalosporium recifei, etc. There have been several previous reports of human invasive infections by Paecilomyces lilacinus causing endophthalmitis, keratitis, chronic sinusitis, skin and soft tissue infections, and catheter-related infections. We report a case of eumycetoma caused by P. lilacinus. To our knowledge, this is the first report of P. lilacinus causing eumycetoma of the foot in the English literature.
Topics: Antifungal Agents; Biopsy; Dermatomycoses; Foot Dermatoses; Humans; Itraconazole; Male; Middle Aged; Mycetoma; Paecilomyces; South Africa
PubMed: 19659864
DOI: 10.1111/j.1365-4632.2008.04047.x -
PLoS Neglected Tropical Diseases Mar 2014Madurella mycetomatis is the main causative organism of eumycetoma, a persistent, progressive granulomatous infection. After subcutaneous inoculation M. mycetomatis...
Madurella mycetomatis is the main causative organism of eumycetoma, a persistent, progressive granulomatous infection. After subcutaneous inoculation M. mycetomatis organizes itself in grains inside a granuloma with excessive collagen accumulation surrounding it. This could be contributing to treatment failure towards currently used antifungal agents. Due to their pivotal role in tissue remodelling, matrix metalloproteinases-2 (MMP-2) and 9 (MMP-9) or tissue inhibitor of metalloproteinases (TIMP) might be involved in this process. Local MMP-2 and MMP-9 expression was assessed by immunohistochemistry while absolute serum levels of these enzymes were determined in mycetoma patients and healthy controls by performing ELISAs. The presence of active MMP was determined by gelatin zymography. We found that both MMP-2 and MMP-9 are expressed in the mycetoma lesion, but the absolute MMP-2, -9, and TIMP-1 serum levels did not significantly differ between patients and controls. However, active MMP-9 was found in sera of 36% of M. mycetomatis infected subjects, whereas this active form was absent in sera of controls (P<0.0001). MMP-2, MMP-9, and TIMP-1 polymorphisms in mycetoma patients and healthy controls were determined through PCR-RFLP or sequencing. A higher T allele frequency in TIMP-1 (+372) SNP was observed in male M. mycetomatis mycetoma patients compared to controls. The presence of active MMP-9 in mycetoma patients suggest that MMP-9 is activated or synthesized by inflammatory cells upon M. mycetomatis infection. Inhibiting MMP-9 activity with doxycycline could prevent collagen accumulation in mycetoma, which in its turn might make the fungus more accessible to antifungal agents.
Topics: Blood Chemical Analysis; Collagen; Electrophoresis; Enzyme-Linked Immunosorbent Assay; Female; Genotype; Histocytochemistry; Humans; Madurella; Male; Matrix Metalloproteinase 9; Mycetoma; Polymorphism, Genetic; Polymorphism, Restriction Fragment Length; Sex Factors
PubMed: 24675764
DOI: 10.1371/journal.pntd.0002754 -
Journal of Medical and Veterinary... 1995In this prospective study, three types of tissue reaction to mycetoma grains are described. Type I reaction is characterized by the adherence of neutrophils to the...
In this prospective study, three types of tissue reaction to mycetoma grains are described. Type I reaction is characterized by the adherence of neutrophils to the surface of the grain leading to its disintegration. In Type II reaction, the fragmented grain and the dead neutrophils are cleared by macrophages and multinucleated giant cells, while in Type III reaction there is a discrete well developed epithelioid granuloma with Langhans's giant cells. The three types of reaction are usually seen in different combinations in the same lesion.
Topics: Adolescent; Adult; Child; Dermatomycoses; Female; Foreign-Body Reaction; Humans; Male; Middle Aged; Mitosporic Fungi; Prospective Studies
PubMed: 7650573
DOI: No ID Found -
Revista Do Instituto de Medicina... 2017Mycetoma is a chronic granulomatous disease, classified into eumycetoma caused by fungi and actinomycetoma due to aerobic filamentous actinomycetes. Mycetoma can be...
Mycetoma is a chronic granulomatous disease, classified into eumycetoma caused by fungi and actinomycetoma due to aerobic filamentous actinomycetes. Mycetoma can be found in geographic areas near the Tropic of Cancer. Mexico is one of the countries in which actinomycetoma is endemic. We report an extraordinary case of an adult male with double eumycetoma caused by Madurella mycetomatis and Fusarium verticillioides on both feet.
Topics: Foot Dermatoses; Fusarium; Humans; Madurella; Male; Middle Aged; Mycetoma
PubMed: 28793023
DOI: 10.1590/S1678-9946201759055 -
Journal of Immunology (Baltimore, Md. :... Aug 2006About 40 years ago Abs against the fungus Madurella mycetomatis were first demonstrated to be present in eumycetoma patients, a disease characterized by tumorous...
About 40 years ago Abs against the fungus Madurella mycetomatis were first demonstrated to be present in eumycetoma patients, a disease characterized by tumorous swellings. To date nothing is known about the individual immunoreactive Ags present in this fungus. In the present study, we identify its first immunogenic Ag, a protein homologous to the translationally controlled tumor protein (TCTP), a well-conserved histamine release factor in a range of eukaryotes. The gene for this Ag was demonstrated to be present in two variants in M. mycetomatis, with 13% aa difference between the two proteins encoded. In vitro, TCTP was secreted into the culture medium. In vivo, it was found to be expressed on hyphae present in developing stages of the eumycetoma-characteristic black grain. Significant IgG and IgM immune responses, against the whole protein and selected M. mycetomatis-specific peptides, were determined. The Ab levels correlated with lesion size and disease duration. Overall, the patients with the largest lesions had the highest Ab level, which lowered with decreasing size of the lesion. After 6-15 years of disease duration the Ab levels were the highest. TCTP is the first well-characterized immunogenic Ag, simultaneously the first monomolecular vaccine candidate, identified for the fungus M. mycetomatis.
Topics: Adult; Amino Acid Sequence; Animals; Antibodies, Fungal; Antibodies, Neoplasm; Antigens, Fungal; Antigens, Neoplasm; Bacteriophage lambda; Base Sequence; Biomarkers, Tumor; Disease Progression; Edible Grain; Female; Gene Library; Humans; Madurella; Mice; Mice, Inbred BALB C; Molecular Sequence Data; Mycetoma; Protein Biosynthesis; Sequence Homology, Amino Acid; Tumor Protein, Translationally-Controlled 1
PubMed: 16849514
DOI: 10.4049/jimmunol.177.3.1997 -
Medical Journal, Armed Forces India Apr 2001
PubMed: 27407327
DOI: 10.1016/S0377-1237(01)80144-1