The Mycetoma Research Center, University of Khartoum, Khartoum, Sudan.
Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, University of Rotterdam, Rotterdam, The Netherlands.
PLoS Negl Trop Dis. 2019 Aug 29;13(8):e0007056. doi: 10.1371/journal.pntd.0007056. eCollection 2019 Aug.
Mycetoma is a devastating neglected tropical disease, caused by various fungal and bacterial pathogens. Correct diagnosis to the species level is mandatory for proper treatment. In endemic areas, various diagnostic tests and techniques are in use to achieve that, and that includes grain culture, surgical biopsy histopathological examination, fine needle aspiration cytological (FNAC) examination and in certain centres molecular diagnosis such as PCR. In this retrospective study, the sensitivity, specificity and diagnostic accuracy of grain culture, surgical biopsy histopathological examination and FNAC to identify the mycetoma causative organisms were determined. The histopathological examination appeared to have better sensitivity and specificity. The histological examination results were correct in 714 (97.5%) out of 750 patients infected with Madurella mycetomatis, in 133 (93.6%) out of 142 patients infected with Streptomyces somaliensis, in 53 (74.6%) out of 71 patients infected with Actinomadura madurae and in 12 (75%) out of 16 patients infected with Actinomadura pelletierii. FNAC results were correct in 604 (80.5%) out of 750 patients with Madurella mycetomatis eumycetoma, in 50 (37.5%) out of 133 Streptomyces somaliensis patients, 43 (60.5%) out of 71 Actinomadura madurae patients and 11 (68.7%) out of 16 Actinomadura pelletierii. The mean time required to obtain the FNAC result was one day, and for the histopathological examinations results it was 3.5 days, and for grain it was a mean of 16 days. In conclusion, histopathological examination and FNAC are more practical techniques for rapid species identification than grain culture in many endemic regions.
足菌肿是一种具有破坏性的热带被忽视疾病，由各种真菌和细菌病原体引起。正确鉴定到种属水平对于恰当的治疗是强制性的。在流行地区，使用各种诊断测试和技术来实现这一目标，包括谷物培养、外科活检组织病理学检查、细针抽吸细胞学（FNAC）检查以及在某些中心进行分子诊断，如 PCR。在这项回顾性研究中，确定了谷物培养、外科活检组织病理学检查和 FNAC 识别足菌肿病原体的敏感性、特异性和诊断准确性。组织病理学检查似乎具有更好的敏感性和特异性。组织学检查结果在 750 例感染 Madurella mycetomatis 的患者中有 714 例（97.5%）、142 例感染 Streptomyces somaliensis 的患者中有 133 例（93.6%）、71 例感染 Actinomadura madurae 的患者中有 53 例（74.6%）和 16 例感染 Actinomadura pelletierii 的患者中有 12 例（75%）是正确的。FNAC 结果在 750 例 Madurella mycetomatis 真霉肿患者中有 604 例（80.5%）、133 例 Streptomyces somaliensis 患者中有 50 例（37.5%）、71 例 Actinomadura madurae 患者中有 43 例（60.5%）和 16 例 Actinomadura pelletierii 患者中有 11 例（68.7%）是正确的。获得 FNAC 结果的平均时间为 1 天，组织病理学检查结果为 3.5 天，谷物培养结果为 16 天。总之，在许多流行地区，组织病理学检查和 FNAC 比谷物培养更实用，可用于快速鉴定种属。
