Mycetoma (also known as astinomycotic mycetoma or maduromycosis), is a slow-growing bacterial or fungal infection focused in one area of the body, usually the foot. For this reason-and because the first medical reports were from doctors in Madura, India-an alternate name for the disease is Madura foot. The infection is characterized by an abnormal tissue mass beneath the skin, formation of cavities within the mass, and a fluid discharge. As the infection progresses, it affects the muscles and bones; at this advanced stage, disability may result.
- Slow spreading skin infection
- Local swelling
- Pus on skin
- Small hard painless nodules
- Pus discharge
- Holes in skin
- Scarred skin
- Pale skin
- Burning sensation
- Madurella mycetomi
- Streptomyces somaliensis
Mycetoma is a rare condition that is not contagious.
The primary symptoms of a tumor, sinuses, and grain-flecked discharge often provide enough information to diagnose mycetoma. In the early stages, prior to sinus formation, diagnosis may be more difficult and a biopsy, or microscopic examination of the tissue, may be necessary. If bone involvement is suspected, the area is x rayed to determine the extent of the damage. The species of bacteria or fungi at the root of the infection is identified by staining the discharge grains and inspecting them with a microscope.
Recovery from mycetoma may take months or years, and the infection recurs after surgery in at least 20% of cases. Drug therapy can reduce the chances of a re-established infection. The extent of deformity or disability depends on the severity of infection; the more deeply entrenched the infection, the greater the damage. By itself, mycetoma is rarely fatal, but secondary infections can be fatal.
Combating mycetoma requires both surgery and drug therapy. Surgery usually consists of removing the tumor and a portion of the surrounding tissue. If the infection is extensive, amputation is sometimes necessary. Drug therapy is recommended in conjunction with surgery. The specific prescription depends on the type of bacteria or fungi causing the disease. Common medicines include antifungal drugs, such as ketoconazole and antibiotics (streptomycin sulfate, amikacin, sulfamethoxazole, penicillin, and rifampin).