Mycetoma (Madura Foot)
Introduction
Is a chronic infection of skin and subcutaneous tissue. It can be caused infection by fungi or bacteria. Once tests have established the etiology, the term Actinomycetoma is used for bacterial form, while Eumycetoma is used for the fungal form. Clinical presentation depends on the affected site and the disease can last for months to years
Signs & symptoms
• First lesion: nodule
• Localisation: feet, legs, arms, buttocks, scalp, trunk
• Discharging sinuses where grains may be visible usually white yellow for Actinomycetoma or black for Eumycetoma
• Pain before rupture of discharging sinus
Diagnostic criteria
• First lesion: nodule
• Localisation: feet, legs, arms, buttocks, scalp, trunk
• Discharging sinuses where grains may be visible usually white yellow for Actinomycetoma or black for Eumycetoma
• Pain before rupture of discharging sinus
Investigation
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Treatment
-
Non-Pharmacological treatment
- • Surgery where indicated
• Footwear and protective clothing in at-risk populations e.g. those in contact with contaminated cattle dung
-
Pharmacological
- • Co-trimoxazole (PO) 480mg–960mg 12 hourly for 5 weeks
AND
• Streptomycin or Amikacin for 5 weeks
OR
• Co-trimoxazole (PO) 480 mg–960 mg 12 hourly for 5 weeks
AND
• Dapsone (PO). Adults: 100 mg once a day for 2–4 months; Children: 25–50 mg once a day for 5 weeks
NOTE : Regular blood tests must be done when co-trimoxazole is used for more than 14 days Treatment of Eumycetoma (Fungi fom)
Fungal form
• Itraconazole tabs 200mg (PO) twice daily for 5 weeks or longer (up to a year). Normally follows surgical removal
Prevention
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Updated on,
3 Novemba 2020 11:20:19
References
- 1.STG