Eumycetoma

Eumycetoma, also known as Madura foot, is a persistent fungal infection of the skin and the tissues just under the skin, affecting most commonly the feet, although it can occur within other body parts. It starts as a painless wet nodule, which may be present for years before ulceration, swelling, bone degradation, and grainy discharge from sinuses and fistulae set in. Many different species of fungi can cause eumycetoma, some examples include: Madurella mycetomatis, Falciformispora senegalensis, Curvularia lunata, Scedosporium species, Acremonium and Fusarium species. Diagnosis is normally done by histopathology and culture. Medical imaging may reveal extent of bone involvement. Other tests include ELISA, immunodiffusion, and Fungal DNA barcoding Treatment includes surgical removal of affected tissue and antifungal medicines. After treatment, recurrence is common. Sometimes limb amputation is required. The infection occurs generally in the tropics, and is endemic in Sub-Saharan Africa, especially Sudan, India, parts of South America and Mexico. Few cases have been reported across North Africa. Mycetoma is probably low-endemic to Egypt with predilection for eumycetoma. In 2016, the World Health Organization recognised eumycetoma as a neglected tropical disease.