Defining the best time to initiate therapy and treatment goals in negative culture mycetoma: A case from a non-endemic country
DOI:
https://doi.org/10.66344/jpad.v34i1.2450Keywords:
mycetoma, treatment, non-endemic country, negative-cultureAbstract
Mycetoma is a chronic granulomatous suppurative disease of the skin and underlying tissue caused by saprophytic fungus (eumycetoma) or actinomycetes (actinomycetoma). Despite having a low prevalence and low mortality rate, mycetoma may cause serious complications such as deformity and disability due to destruction of skin and adjacent structures. Various therapeutic options call for a thorough diagnostic approach before initiating therapy. Prompt treatment is imperative to limit disabilities. Furthermore, mycetoma is prone to recurrences, hence rigorous assessment of therapeutic goal is essential. We reported a case of actinomycetoma confirmed by histopathology examination and successfully treated with combination of rifampicin and cotrimoxazole.
References
1. Kusmarinah Bramono. Aktinomisetoma. In: Bramono K, Suyoso S, Widaty S, Ramali LM, Siswati AS, Ervianti AV, editors. Mikosis Profunda. 1st ed. Surabaya: Airlangga University Press; 2019. p. 53–65.
2. Reis CMS, Reis-Filho EG de M. Mycetomas: an epidemiological, etiological, clinical, laboratory and therapeutic review. Anais brasileiros de dermatologia. 2018;93:8–18.
3. World Health Organization. Neglected tropical diseases [Internet]. WHO. [cited 2023 Feb 19]. Available from: https://www.who.int/health-topics/neglected-tropical-diseases
4. Eliza Miranda. Eumisetoma. In: Bramono K, Suyoso S, Widaty S, Ramali LM, Siswati AS, Ervianti AV, editors. Mikosis Profunda. 1st ed. Surabaya: Airlangga University Press; 2019. p. 41–52.
5. Relhan V, Mahajan K, Agarwal P, Garg VK. Mycetoma: an update. Indian J Dermatol. 2017;62(4):332.
6. Suyoso S, Ervianti AV, Astari L, Anggraeni S, Widia Y. Pendahuluan: mikosis profunda. In: Bramono K, Widaty S, Ramali LM, Siswati AS, Ervianti AV, editors. Mikosis Profunda. 1st ed. Surabaya: Airlangga University Press; 2019. p. 53–65.
7. Yahya S, Widaty S, Miranda E, Bramono K, Islami AW. Subcutaneous mycosis at the department of dermatology and venereology dr. Cipto Mangunkusumo National Hospital, Jakarta, 1989-2013. J Gen Proc Dermatol Venereol Indonesia. 2016;1(2):1.
8. Efared B, Tahiri L, Boubacar MS, Atsam-Ebang G, Hammas N, Hinde EF, et al. Mycetoma in a non-endemic area: a diagnostic challenge. BMC Clin Pathol. 2017;17(1):1–6.
9. Zeeshan M, Fatima S, Farooqi J, Jabeen K, Ahmed A, Haq A, et al. Reporting of mycetoma cases from skin and soft tissue biopsies over a period of ten years: A single center report and literature review from Pakistan. PLoS Neg Trop Dis. 2022;16(7):e0010607.
10. Bakshi R, Mathur DR. Incidence and changing pattern of mycetoma in western Rajasthan. Indian J Pathol Microbiol. 2008;51(1):154.
11. Argentina F, Karim PL. Extensive Actinomycetoma Clinical Manifestations and Histopathology: A Case Report. Bioscientia Medicina: J Biomed Transl Res. 2022;6(15):2705–12.
12. Liu A, Maender JL, Coleman N, Hsu S, Rosen T. Actinomycetoma with negative culture: a therapeutic challenge. Dermatol Online J. 2008;14(4). Available from: https://escholarship.org/uc/item/19m6r34k
13. Bravo FG, Arenas R, Sigall DA. Actinomycosis, nocardiosis, and actinomycetoma. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al. editors. Fitzpatrik’s Dermatology. 9th ed. New York: McGraw-Hill Education; 2019. p. 2876–91.
14. Sampaio FMS, Wanke B, Freitas DFS, Coelho JMC de O, Galhardo MCG, Lyra MR, et al. Review of 21 cases of mycetoma from 1991 to 2014 in Rio de Janeiro, Brazil. PLoS Neg Trop Dis. 2017;11(2):1–18.
15. Patra S, Senthilnathan G, Ramam M, Arava S, Bhari N. Linezolid: A novel treatment option for the treatment of a non-responsive case of actinomycotic mycetoma. Indian J Dermatol Venereol Leprol. 2021;87(3):473–5.
16. Husain U, Verma P, Suvirya S, Priyadarshi K, Gupta P. An overview of mycetoma and its diagnostic dilemma: time to move on to advanced techniques. Indian J Dermatol Venereol Leprol. 2023;89(1):12–7.
17. Hao X, Cognetti M, Burch-Smith R, Mejia EO, Mirkin G. Mycetoma: Development of Diagnosis and Treatment. J Fungi. 2022;8(7):743.
18. van de Sande WW. Global burden of human mycetoma: a systematic review and meta-analysis. PLoS Neg Trop Dis. 2013;7(11):e2550.
19. Fahal A, Mahgoub ES, Hassan AME, Abdel-Rahman ME. Mycetoma in the Sudan: an update from the mycetoma research centre, University of Khartoum, Sudan. PLoS Neg Top Dis. 2015;9(3):e0003679.
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