Laboratory of Parasitology and Mycology, Aristide Le Dantec University Hospital, Dakar, Senegal.
Service of Parasitology-Mycology, Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University of Dakar, Dakar, Senegal.
PLoS Negl Trop Dis. 2021 Mar 25;15(3):e0009238. doi: 10.1371/journal.pntd.0009238. eCollection 2021 Mar.
Mycetoma is a neglected tropical disease which is endemic in Senegal. Although this subcutaneous mycosis is most commonly found on the foot, extrapodal localisations have also been found, including on the leg, knee, thigh, hand, and arm. To our knowledge, no case of blood-spread eumycetoma has been reported in Senegal. Here, we report a case of pulmonary mycetoma secondary to a Madurella mycetomatis knee eumycetoma. The patient was a 41-year-old farmer living in Louga, Senegal, where the Sudano-Sahelian climate is characterised by a short and unstable rainy season and a steppe vegetation. He suffered a trauma to the right more than 20 years previously and had received treatment for more than 10 years with traditional medicine. He consulted at Le Dantec University Hospital in Dakar for treatment of a right knee mycetoma which had been diagnosed more than 10 years ago. He had experienced a chronic cough for more than a year; tuberculosis documentation was negative. Grains collected from the knee and the sputum isolated M. mycetomatis, confirmed by the rRNA gene ITS regions nucleotide sequence analysis. An amputation above the knee was performed, and antibacterial and antifungal therapy was started with amoxicillin-clavulanic acid and terbinafine. The patient died within a month of his discharge from hospital.
足菌肿是一种被忽视的热带病，在塞内加尔流行。虽然这种皮下真菌感染最常发生在脚部，但也有 extrapodal 部位的定位，包括腿部、膝盖、大腿、手部和手臂。据我们所知，塞内加尔没有报告过血行播散的外瓶霉病病例。在这里，我们报告了一例由 Madurella mycetomatis 膝关节外瓶霉病引起的肺真菌肿。患者是一名 41 岁的农民，居住在塞内加尔的卢加，那里的苏丹-萨赫勒气候特点是短暂而不稳定的雨季和草原植被。他 20 多年前右腿受伤，接受了 10 多年的传统医学治疗。他在达喀尔的 Le Dantec 大学医院就诊，治疗 10 多年前诊断出的右膝真菌肿。他持续慢性咳嗽超过一年；结核病文件为阴性。从膝盖和痰液中收集的谷物分离出 M. mycetomatis，通过 rRNA 基因 ITS 区核苷酸序列分析得到证实。进行了膝关节以上的截肢，并开始使用阿莫西林克拉维酸和特比萘芬进行抗菌和抗真菌治疗。患者在出院后一个月内死亡。
