Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Ann Clin Microbiol Antimicrob. 2018 Aug 10;17(1):35. doi: 10.1186/s12941-018-0287-4.
Mycetoma is a chronic mutilating disease of the skin and the underlying tissues caused by fungi or bacteria. Although recently included in the list of neglected tropical diseases by the World Health Organization, strategic control and preventive measures are yet to be outlined. Thus, it continues to pose huge public health threat in many tropical and sub-tropical countries. If not detected and managed early, it results into gruesome deformity of the limbs. Its low report and lack of familiarity may predispose patients to misdiagnosis and delayed treatment initiation. More so in situation where diagnostic tools are limited or unavailable, little or no option is left but to clinically diagnose these patients. Therefore, an overview of clinical course of mycetoma, a suggested diagnostic algorithm and proposed use of materials that cover the exposed susceptible parts of the body during labour may assist in the prevention and improvement of its management. Furthermore, early reporting which should be encouraged through formal and informal education and sensitization is strongly suggested.
An overview of the clinical presentation of mycetoma in the early and late phases, clues to distinguish eumycetoma from actinomycetoma in the field and the laboratory, differential diagnosis and a suggested diagnostic algorithm that may be useful in making diagnosis amidst the differential diagnosis of mycetoma is given. Additionally, a proposed preventive measures which may be helpful in the community is also provided. Since treatment is currently based on expert opinion, we encourage active research to establish treatment guideline for it.
Since delay in visiting health facility results into gruesome complication, early presentation, recognition and initiation of appropriate choice of regimen is helpful in reducing complications. The clinical overview of mycetoma and the suggested algorithm may enhance suspicion and possibly increase recognition of mycetoma in the community and further guide in differentiation of eumycetoma from actinomycetoma. There is an urgent need for research funding for mycetoma, a disease plagued by severe physical disabilities and social stigma leading to isolation.
足菌肿是一种由真菌或细菌引起的慢性、进行性皮肤和皮下组织破坏性疾病。尽管最近世界卫生组织将其列入被忽视的热带病清单，但仍需制定战略控制和预防措施。因此，它在许多热带和亚热带国家仍然构成巨大的公共卫生威胁。如果早期未被发现和管理，它会导致四肢可怕的畸形。由于报告率低且缺乏熟悉度，患者可能会误诊并延迟开始治疗。在诊断工具有限或不可用时，情况更是如此，几乎没有选择，只能对这些患者进行临床诊断。因此，本文概述了足菌肿的临床过程，提出了一种诊断算法，并建议在分娩时使用覆盖身体暴露部位的材料，这可能有助于预防和改善其管理。此外，强烈建议通过正式和非正式的教育和宣传鼓励早期报告。
本文概述了早期和晚期足菌肿的临床表现、在现场和实验室中区分真菌肿和放线菌肿的线索、鉴别诊断以及有助于在鉴别诊断中做出诊断的建议诊断算法。此外，还提供了一些可能有助于社区的预防措施。由于目前的治疗是基于专家意见，我们鼓励积极开展研究，为其制定治疗指南。
由于延迟就诊会导致严重的并发症，因此早期就诊、识别和选择适当的治疗方案有助于减少并发症。本文对足菌肿的临床概述和建议的算法可以提高社区对足菌肿的怀疑和认识，并进一步指导区分真菌肿和放线菌肿。由于足菌肿这种疾病会导致严重的身体残疾和社会耻辱，导致隔离，因此迫切需要为其研究提供资金。
