Abstract
Introduction: Mycetoma is a chronic granulomatous inflammatory disease predominantly affecting the foot and hand. The cervical region is an uncommon site for mycetoma and spinal cord compression is a rare complication. Case presentation: This communication reports on a 40-year-old male farmer from Western Sudan who presented with quadriparesis due to cervical spine cord compression caused by Actinomadura pelletieri actinomycetoma. His condition started with a small painless subcutaneous swelling in the right shoulder region that gradually increased in size to involve the right side of the neck and the cervical spinal cord ending in progressive quadriparesis. He made a good response to an extended course of antibiotics, but was left with mild disability. Conclusions: A. pelletieri is an uncommon cause of actinomycetoma, and the clinical presentation of the reported patient is a rare and serious sequela of mycetoma. The literature contains only a very few reports on such presentation, and our case report will add to the knowledge and experience in managing such a presentation.
Highlights
Mycetoma is a chronic granulomatous inflammatory disease predominantly affecting the foot and hand
The reported patient presented with quadriparesis due to cervical spinal cord compression caused by actinomycetoma, which is a serious and potentially fatal condition
A 40-year-old male farmer from Western Sudan was referred to the Mycetoma Research Centre, Khartoum, Sudan with a history of bilateral upper and lower limb severe weakness rendering him immobile for 45 days
Summary
Mycetoma is a neglected tropical disease, which is endemic in many tropical and subtropical areas in what is known as the mycetoma belt (Fahal, 2004). Six years prior to presentation he noted a small painless right shoulder swelling. It progressively increased in size, and involved the right aspect of the neck and extended posteriorly towards the back of the neck. The patient could not recall a history of trauma at the swelling site He initially presented to a district hospital where he received some medication for 2 months. There was a reduction in the size of the swelling; the patient was not aware of the diagnosis or medication given He had no medical co-morbidities, no previous surgical intervention and he was not on regular medications. Chest X-ray revealed a soft tissue mass between the right shoulder and neck, and otherwise normal lungs. Six months later he continued to improve and was able to mobilise independently with a minor disability
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have