Mycetoma

A chronic progressive subcutaneous infection caused by species of fungi (eumycetoma), or actinomycetes (actinomycetoma). It is characterized by tumefaction, abscesses, and tumor-like granules representing microcolonies of pathogens, such as MADURELLA fungi and bacteria ACTINOMYCETES, with different grain colors.

Also Known As:

Networked: 411 relevant articles (39 outcomes, 31 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Mycetoma
2.	Infections
3.	Chromoblastomycosis (Chromomycosis)
4.	Mycoses (Diseases, Fungus)
5.	Hemoptysis

Experts

1.	van de Sande, Wendy W J: 32 articles (02/2022 - 04/2005)
2.	Fahal, Ahmed H: 19 articles (01/2021 - 03/2007)
3.	Fahal, Ahmed: 13 articles (06/2022 - 03/2002)
4.	Fahal, Ahmed Hassan: 12 articles (01/2022 - 06/2014)
5.	Welsh, Oliverio: 11 articles (01/2020 - 03/2004)
6.	van Belkum, Alex: 11 articles (05/2016 - 03/2002)
7.	Vera-Cabrera, Lucio: 10 articles (01/2020 - 03/2004)
8.	Lim, Wilson: 8 articles (06/2022 - 01/2018)
9.	Bonifaz, Alexandro: 7 articles (06/2022 - 11/2004)
10.	Verbon, Annelies: 7 articles (06/2022 - 01/2020)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Mycetoma:

1.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/1985 - "We propose a therapeutic trial in a greater number of severe cases of mycetoma with the last antibiotic association in order to evaluate its therapeutic efficacy." 03/01/1989 - "In vitro studies of antibiotic sensitivities of Streptomyces somaliensis--a cause of human actinomycetoma." 12/23/2022 - "Using this assay, reproducible MICs were determined for the most commonly used antibacterial agents for actinomycetoma treatment. " 03/01/2021 - "Abdominal actinomycetoma should be considered as a differential diagnosis of any abdominal wall mass for patients with known risk factors and surgery and antibiotics are the only curative treatment." 01/01/2021 - "The disease was managed by antibiotic treatment alone and resulted in complete cure after 6 months of treatment, which is quick when compared with actinomycetoma cases caused by other Actinomadura species."
2.	Itraconazole (Sporanox)FDA LinkGeneric 04/01/2021 - "On the other hand, a clinical trial for eumycetoma in collaboration with DNDi is ongoing supported by the Global Health Innovative Technology Fund, and is examining the efficacy of weekly treatment with E1224 versus the current standard of care, daily treatment with itraconazole. " 03/01/2011 - "This prospective study aimed to determine the safety and efficacy of itraconazole for the treatment of patients with mycetoma due to Madurella mycetomatis. " 03/01/2011 - "The safety and efficacy of itraconazole for the treatment of patients with eumycetoma due to Madurella mycetomatis." 10/23/2023 - "In this study, we measured (1,3)-β-D-glucan concentrations in serum with the WAKO (1,3)-β-D-glucan assay in 104 patients with eumycetoma treated with either 400 mg itraconazole daily, or 200 mg or 300 mg fosravuconazole weekly. " 11/01/2021 - "A Case of Bilateral Painful Eumycetoma of the Feet Responding Excellently to Low Dose Itraconazole."
3.	posaconazoleFDA Link 08/01/2011 - "Madurella mycetomatis mycetoma treated successfully with oral posaconazole." 05/01/2009 - "Successful therapy with ABLC, surgery and posaconazole for Rhizopus microsporus var. rhizopodiformis liver eumycetoma in a child with acute leukaemia." 01/01/2015 - "Paradoxical response preceding control of Scedosporium apiospermum mycetoma with posaconazole treatment." 11/01/2005 - "As part of a treatment-use extension protocol, two patients with eumycetoma who initially had successful outcome were successfully retreated with posaconazole after a treatment hiatus of > 10 months. " 04/01/2011 - "Since posaconazole has an excellent safety profile, it might provide an important alternative in mycetoma therapy."
4.	Amikacin (A.M.K)FDA LinkGeneric 01/01/2000 - "The first therapeutic scheme is very useful in the treatment of Nocardia mycetoma, while the association of amikacin plus SMT is the best treatment for those cases produced by Actinomadura madurae. " 07/01/2011 - "This is a rare presentation of mycetoma of the scalp that was cured in 12 weeks with a combination of amikacin and SXT." 12/01/2013 - "Ramam regimen was found to be quite effective in treating patients of actinomycetoma with only minimal bony involvement, while Welsh regimen and its modification should be used in case of severe disease due to amikacin being more sensitive than gentamicin in treating resistant organisms. " 05/01/2006 - "[Actinomycetoma and Nocardia sp. Report of five cases treated with imipenem or imipenem plus amikacin]." 05/01/2006 - "Since Actinomycetoma is sensitive to drug treatment, the patient was given trimethoprim-sulfamethoxazole and amikacin twice daily for 45 days. "
5.	Terbinafine (Lamisil)FDA LinkGeneric 02/01/2006 - "An open-label study was performed to assess the efficacy and safety of terbinafine in the treatment of eumycetoma. " 10/01/2020 - "Herein 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. " 05/01/2017 - "Eumycetoma caused by Trichophyton species successfully treated with terbinafine and surgery." 04/14/2017 - "Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature." 12/01/2008 - "Successful resolution of dermatophyte mycetoma following terbinafine treatment in two cats."
6.	Amphotericin B (Amphotericin)FDA LinkGeneric 08/01/1995 - "Because of larger particles and significantly greater inhaled mass, Fisoneb delivered more amphotericin B to the central airways, the lung periphery and in the mycetoma lung regions. " 10/01/1978 - "Amphotericin B and maduromycosis." 04/01/2020 - "Successful Limb Salvage in a Case of Advanced Long-Standing Eumycetoma of the Foot Using Adjunctive Local Amphotericin B Delivery Through Bioabsorbable Beads." 03/01/1977 - "While the active pulmonary and extra-pulmonary lesions responded well to therapy with amphotericin B, resection was required to eliminate the residual mycetoma and its attendant hemoptysis." 12/01/2015 - "Amphotericin B but not itraconazole is able to prevent grain formation in experimental Madurella mycetomatis mycetoma in mice."
7.	Antifungal AgentsIBA 01/01/2023 - "An update on the development of novel antifungal agents for eumycetoma." 04/01/2015 - "Here we determined the in vitro activity of eight antifungal agents against seven species causing human eumycetoma using the Sensititre YeastOne method. " 04/01/2015 - "Despite the different phylogenetic positions of black-grain eumycetoma species, they are all treated with the same antifungal agents. " 01/01/2015 - "Interestingly, although grain formation is key in mycetoma, its formation process and its susceptibility towards antifungal agents are not well understood. " 05/01/1993 - "A pathologic examination suggested that the old mycetoma was for the most part comprised of dead mycelial cells, against which antifungal agents were not effective. "
8.	AntibodiesIBA 01/01/2001 - "[Anti-Nocardia brasiliensis antibodies in patients with actinomycetoma and their clinical usefulness]." 02/01/1987 - "Antibodies directed against the fungi in vitro were shown, by indirect immunogold labelling, to bind at identical sites in fungal material grown in vitro as in mycetoma grains. " 11/01/1977 - "The mycetoma so formed can be specifically diagnosed by finding precipitating antibodies to A. " 11/16/2022 - "Retraction for Chu et al., "Association of Presence of Aspergillus Antibodies with Hemoptysis in Patients with Old Tuberculosis or Bronchiectasis but No Radiologically Visible Mycetoma"." 02/01/2004 - "A 17-month prospective study was carried out to compare the prevalence of Aspergillus fumigatus and Aspergillus flavus antibodies in hemoptysis patients with old tuberculosis or bronchiectasis but no radiologically visible mycetoma (cases, n = 38), hemoptysis patients with other diagnosis (control group 1, n = 29), and patients with old tuberculosis or bronchiectasis but no hemoptysis (control group 2, n = 47) by a recently developed sensitive and specific A. "
9.	Ciprofloxacin (Cipro)FDA LinkGeneric 03/01/2022 - "Treatment based on streptomycin + TMP/SMX with ciprofloxacin was found to be effective in treating patients with actinomycetoma, and comparable to the conventional treatment with DDS in actinomycetoma due to A. " 01/01/2009 - "Efficacy of ciprofloxacin and moxifloxacin against Nocardia brasiliensis in vitro and in an experimental model of actinomycetoma in BALB/c mice." 12/01/2014 - "We report a case of Madura foot in a Somali refugee successfully managed with oral posaconazole and ciprofloxacin. " 12/01/2014 - "Case report: Non-invasive management of Madura foot with oral posaconazole and ciprofloxacin." 01/01/2006 - "The following etiological agents were identified: Madurella grisea 29 cases, Actinomadura madurae 26, Scedosporium apiospermum 5, Nocardia brasiliensis 5, Acremonium spp. 4 (Acremonium falciforme 2, Acremonium kiliense 1, Acremonium recifei 1), Madurella mycetomatis 3, Fusarium solani 2, Nocardia asteroides 1 and Streptomyces somaliensis 1. The main drugs used in the treatments were ketoconazole and itraconazole for maduromycotic mycetomas, and cotrimoxazole associated with ciprofloxacin or amikacin for actinomycetic mycetoma. "
10.	TriazolesIBA 10/01/2014 - "Last generation triazoles for imported eumycetoma in eleven consecutive adults." 10/01/2011 - "It also reminds us that eumycetoma is a difficult infection to treat and despite optimism regarding the efficacy of the newer triazole antifungals in this condition, treatment failures may still occur." 01/01/2006 - "Strengths of the newer triazoles include increased activity against resistant and emerging pathogens, convenience of oral formulations, and in vivo activity against subcutaneous mycoses, in particular eumycotic mycetoma. " 11/01/2005 - "We evaluated the efficacy of posaconazole, a new extended-spectrum triazole antifungal agent, in 12 patients with eumycetoma or chromoblastomycosis refractory to existing antifungal therapies. "

Therapies and Procedures

1.	Therapeutics 01/01/2019 - "In some rare cases, the heart can also be involved and the resulting cardiac mycetoma can be treated successfully with antimicrobials without the need of surgery, unlike fungal cardiac mycetomas wherein surgery may be required in addition to antimicrobial therapy. " 09/10/2008 - "In México, Nocardia brasiliensis is the main causative agent of mycetoma, producing about 86% of the cases; the gold standard for the therapy of mycetoma by N. " 08/01/2012 - "Both cases were characterized by long-lasting mycetoma that had previously been failed to be cured and had shown resistance to therapy. " 11/01/2023 - "Further studies are needed to determine optimal duration of antifungal therapy and to determine if surgical resection may be needed to manage post-lung transplant mycetoma." 12/01/2021 - "Patients received a median of five prior lines of therapy, seven with intermediate or adverse cytogenetics, three with concurrent central nervous system (CNS) leukaemia, and one with concurrent CNS mycetoma. "
2.	Surgical Amputation (Amputations) 11/01/2012 - "The study objective was to determine the predictors of cure, amputation and follow-up dropout among the studied individuals with mycetoma. " 01/01/2023 - "Eumycetoma, a chronic subcutaneous mycosis, responds poorly to the available antifungal treatments and patients often require extensive surgical resection or amputation of the affected limb. " 01/01/2023 - "Remarkably, no patient with actinomycetoma underwent an amputation. " 01/01/2023 - "Only 6.1% of eumycetoma patients underwent amputation. " 11/11/2020 - "Mycetoma commonly involves lower extremities, wherein untreated cases lead to aggressive therapeutic choices, such as amputation of the affected body organs and consequently lifelong disability. "
3.	Debridement 03/01/2015 - "The patient was diagnosed as a case of madura foot and the lesions responded to surgical debridement and anti-fungal treatment with a good functional outcome. " 01/01/2016 - "Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. " 09/01/2006 - "Differentiation of dermatophyte-induced mycetoma from kerion is important because mycetomas require a combined approach including surgical debridement in addition to oral antifungal therapy." 01/01/1999 - "All types of mycetoma infections should be treated with early surgical debridement and tissue culture. " 07/01/2018 - "Studies that evaluated antibiotic and antifungal regimens (any drug, dosage, frequency, duration) as well as surgical interventions (wound debridement, advanced excision or limb amputation) for Madura foot were included. "
4.	Lasers (Laser) 01/01/2017 - "In the study described here we evaluated whether matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry might allow the accurate identification of eumycetoma agents and related fungi. " 01/01/2021 - "More recently, different molecular techniques and matrix-assisted laser desorption ionisation-time of flight mass spectrometry have been included as diagnostic methods for actinomycetoma. " 01/01/2017 - "Rapid and Robust Identification of the Agents of Black-Grain Mycetoma by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry."
5.	Nebulizers and Vaporizers (Inhaler) 08/01/1995 - "The aim of the present study was to characterize amphotericin B aerosols nebulized by ultrasonic and jet nebulizers and to study their deposition and pharmacokinetics in patients with pulmonary mycetoma. "