Ahmed Amel Altayeb, van de Sande Wendy, Fahal Ahmed Hassan
The Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.
Department of Medical Microbiology & Infectious Diseases, Erasmus MC, University of Rotterdam, Rotterdam, the Netherlands.
PLoS Negl Trop Dis. 2017 Aug 24;11(8):e0005638. doi: 10.1371/journal.pntd.0005638. eCollection 2017 Aug.
Mycetoma is a unique neglected tropical disease caused by a substantial number of microorganisms of fungal or bacterial origins. Identification of the causative organism and the disease extension are the first steps in the management of the affected patients and predicting disease treatment outcome and prognosis. Different laboratory-based diagnostic tools and techniques were developed over the years to determine and identify the causative agents. These include direct microscopy and cytological, histopathological, and immunohistochemical techniques in addition to the classical grain culture. More recently, various molecular-based techniques have joined the mycetoma diagnostic armamentarium. The available mycetoma diagnostic techniques are of various specificity and sensitivity rates. Most are invasive, time consuming, and operator dependent, and a combination of them is required to reach a diagnosis. In addition, they need a well-equipped laboratory and are therefore not field friendly. This review aims to provide an update on the laboratory investigations used in the diagnosis of mycetoma. It further aims to assist practising health professionals dealing with mycetoma by outlining the guidelines developed by the Mycetoma Research Centre, University of Khartoum, WHO collaborating centre on mycetoma following a cumulative experience of managing more than 7,700 mycetoma patients.
足菌肿是一种独特的被忽视的热带疾病，由大量真菌或细菌来源的微生物引起。确定病原体和疾病范围是治疗受影响患者以及预测疾病治疗结果和预后的首要步骤。多年来，人们开发了不同的基于实验室的诊断工具和技术来确定和识别病原体。这些技术包括直接显微镜检查以及细胞学、组织病理学和免疫组织化学技术，此外还有经典的颗粒培养法。最近，各种基于分子的技术也加入了足菌肿诊断手段的行列。现有的足菌肿诊断技术具有不同的特异性和灵敏度。大多数技术具有侵入性、耗时且依赖操作人员，需要联合使用多种技术才能做出诊断。此外，它们需要设备完善的实验室，因此对现场诊断不太友好。本综述旨在介绍足菌肿诊断中使用的实验室检查的最新情况。它还旨在通过概述喀土穆大学足菌肿研究中心（世界卫生组织足菌肿合作中心）在管理7700多名足菌肿患者的累积经验基础上制定的指南，帮助处理足菌肿的执业卫生专业人员。
