Elgallali N, El Euch D, Cheikhrouhou R, Belhadj S, Chelly I, Chaker E, Ben Osman A
Service de dermatologie, Hôpital la Rabta, Tunis, Tunisie.
Med Trop (Mars). 2010 Jun;70(3):269-73.
Mycetoma is a chronic infection of cutaneous and subcutaneous tissue that can be caused by fungi or bacteria. It is endemic in tropical and subtropical areas but rare in Tunisia.
The purpose of this report is to describe epidemioclinical features, treatment and outcomes in patients presenting mycetoma in Tunisia.
The files of all patients treated for mycetoma in the Dermatology Department of La Rabta Hospital in Tunisia from 1982 to 2006 were retrospectively reviewed.
A total of 15 cases of mycetoma were recorded during the study period. There were 6 men and 9 women with a mean age of 53.2 years. The most common clinical presentation was infiltrated erythematous plaques with sinus tracts (fistulas). Lesions were located on the foot in 12 cases. Thirteen patients reported the presence of grains in fluid discharging from fistulas. The cause of mycetoma was actinomycetes, i.e., Actinomadura madurae, in 9 cases and fungus in 6 cases including 3 due to Madurella mycetomi and 2 to Pseudallesheria boydii. Treatment was based on oral antibiotics for actinomycetoma and oral antifungals for eumycetoma.
Mycetoma in Tunisia is still uncommon with a slight female predominance. The foot is the most frequent location. Diagnosis can be accomplished by direct mycologic examination, culture, and histololgy. There is no consensus on treatment that is often prolonged with numerous relapses.
足菌肿是一种皮肤和皮下组织的慢性感染，可由真菌或细菌引起。它在热带和亚热带地区流行，但在突尼斯很少见。
本报告的目的是描述突尼斯足菌肿患者的流行病学临床特征、治疗方法及结果。
回顾性分析了1982年至2006年在突尼斯拉巴塔医院皮肤科接受足菌肿治疗的所有患者的病历。
研究期间共记录了15例足菌肿病例。其中男性6例，女性9例，平均年龄53.2岁。最常见的临床表现是伴有窦道（瘘管）的浸润性红斑斑块。12例病变位于足部。13例患者报告瘘管排出液中有颗粒。足菌肿的病因是放线菌，即马杜拉放线菌，9例；真菌6例，其中3例由裴氏着色霉引起，2例由博伊德假阿利什霉引起。放线菌性足菌肿的治疗以口服抗生素为主，真菌性足菌肿的治疗以口服抗真菌药为主。
突尼斯的足菌肿仍然不常见，女性略占优势。足部是最常见的发病部位。诊断可通过直接真菌学检查、培养和组织学检查来完成。治疗方面尚无共识，治疗通常会延长且多次复发。
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