Abstract
BackgroundMycetoma is an uncommon chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma). It is the prerogative of young men between the third and fourth decade and is transmitted through any trauma causing an inoculating point. The classic clinical triad associates a painless hard and swelling subcutaneous mass, multiple fistulas, and the pathognomonic discharge of grains. Although endemic in many tropical and subtropical countries, mycetoma can also be found in non-endemic areas as in Morocco, and causes then diagnosis problems leading to long lasting complications. Therefore, we should raise awareness of this neglected disease for an earlier management. Under medical treatment however, mycetoma has a slow healing and surgery is often needed, and relapses are possible.Case presentationHerein we report a case of a 64 years old patient, with a history of eumycetoma occurring ten years ago treated with oral terbinafine coupled with surgery. A complete remission was seen after 2 years. He presented a relapse on the previous scar 6 months ago. There wasn’t any bone involvement in the magnetic resonance imaging (MRI). The patient was put under oral terbinafine with a slow but positive outcome.ConclusionThrough this case report, we perform a literature review and highlight the importance of increase awareness of mycetoma in clinical practice especially in non-endemic regions.
Highlights
Mycetoma is a chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria or fungi [1]
Mycetoma was first reported in 1843 by Dr John Gill in Madurai, India [8] and was called “Madura foot”. It is a chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria or fungi [1]
A bacterial origin is found in 60%, whereas fungi are responsible of 40% of cases reported worldwide [2]
Summary
We perform a literature review and highlight the importance of increase awareness of mycetoma in clinical practice especially in non-endemic regions.
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