Mycetoma.

Mycetoma is a chronic granulomatous disease caused by bacteria or true fungi. It affects the skin the underlying tissue and sometimes subjacent bones and organs. The diagnosis of the disease is confirmed by the microscopic identification and by isolating the infecting agent. Actinomycetoma are treated with trimethoprim-sulfamethoxazole and/or diamino-diphenyl-sulfona (DDS). In patients resistant to these treatments adding amikacin cures about 95% of the resistant cases. In true fungi mycetoma, amphotericin B, ketoconazole, itraconazole, and in some cases these combined with surgery is the treatment of choice.