Mycetomas are localized infections that involve cutaneous and subcutaneous tissue, fascia, and bone. Lesions consist of abscesses, granulomata, and draining sinuses. Following implantation of the etiologic agent, the primary lesion becomes locally invasive, indolent, tumorlike. It may also present with small, painless subcutaneous swellings.
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Mycetomas are localized infections that involve cutaneous and subcutaneous tissue, fascia, and bone. Lesions consist of abscesses, granulomata, and draining sinuses. Following implantation of the etiologic agent, the primary lesion becomes locally invasive, indolent, tumorlike. It may also present with small, painless subcutaneous swellings. The lesions rupture, resulting in sinus tracts, swelling and distortion of the infected body part.
Sclerotia are present in pus and in tissue around the draining sinus tracts [ , ]. Prognosis and therapy Mycetomas caused by fungi are usually resistant to chemotherapy [ ], although anecdotal reports of response to long-term therapy with ketoconazole has been appeared [ , ].
Surgical debridement may be necessary, and amputation is sometimes the final step. Histopathology The ulcer or sinus tract opening is surrounded by raised or flat margins. The abscess is filled with pyogenic materials and granules which are often covered by exudate. The wall of the abscess has granulomatous inflammation, chronic inflammation, and granulation tissue. Granules are present in the tissue. Laboratory Direct examination Pus, exudate, or tissue should be macroscopically examined for sclerotia.
Sclerotia are mounted in sterile saline and then crushed. Actinomycete granules are composed of filaments 0. The sclerotia should be washed in sterile water or in an antibiotic solution prior to inoculation.
Some fungi are sensitive to cycloheximide, thus IMA, SDA and a medium containing cycloheximide should be used together. Mycology principal fungi.
Study of a madurella grisea strain isolated from a foot mycetoma
About the author: Michele Rehbein is a double masters student currently attending Western Illinois University in the programs of Biology and Health Sciences, specifically focusing on microbiology and public health. She plans to get her PhD after she has graduated from WIU, but in the meantime has interests in continuing research and gaining experience. This blog was created as a class project through a medical mycology course she is currently in. Madurella General Description: Madurella is a filamentous fungus found in the soil.