University of Kordofan, Al-Ubayyid, Sudan.
Omdurman Teaching Hospital, Khartoum, Sudan.
BMC Infect Dis. 2021 Sep 23;21(1):995. doi: 10.1186/s12879-021-06695-3.
Mycetoma is the most common neglected disease in humans. It is a chronic, progressive, and destructive disease primarily caused by fungi or bacteria characterized by formation of dark pale grains commonly involve skin, soft tissue and rarely bone.
A 19 year old male patient with chronic right ankle pain, swelling and abscess formation for more than 1 year, patient was treated repeatedly with incision and drainage without any success. No X-ray, biopsy or swab for culture and sensitivity had been considered through the course of presentation. Patient was referred to Omdurman hospital where osteomyelitis secondary euomycetoma infection has been confirmed based on radiological and pathological assessment. Patient was treated surgically with aggressive debridement and bone curettage plus postoperative Itraconazole for 1 year.
Clinicians must consider osteomyelitis as important differential diagnosis during initial assessment Eumycetoma infection in adults. Aggressive bone curettage followed by regular X-ray follow up can be limb saving procedure in such cases.
足菌肿是人类最常见的被忽视疾病。它是一种由真菌或细菌引起的慢性、进行性和破坏性疾病，主要表现为形成深色淡色颗粒，通常累及皮肤、软组织，很少累及骨骼。
一名 19 岁男性患者，慢性右踝关节疼痛、肿胀和脓肿形成超过 1 年，患者曾多次接受切开引流治疗，但均未成功。在就诊过程中，未进行 X 光、活检或拭子培养和药敏试验。患者被转诊到奥姆杜尔曼医院，根据影像学和病理学评估，确诊为继发于骨髓炎的外生性足菌肿感染。患者接受了手术治疗，包括积极清创和骨刮除术，术后给予伊曲康唑治疗 1 年。
临床医生在初步评估时必须考虑骨髓炎作为成人外生性足菌肿感染的重要鉴别诊断。在这种情况下，积极的骨刮除术，然后定期进行 X 光随访，可以是一种保留肢体的治疗方法。
