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. 2014 Aug 21;8(8):e3102.
doi: 10.1371/journal.pntd.0003102. eCollection 2014 Aug.

Mycetoma: experience of 482 cases in a single center in Mexico

Alexandro Bonifaz  1 , Andrés Tirado-Sánchez  1 , Luz Calderón  1 , Amado Saúl  1 , Javier Araiza  1 , Marco Hernández  1 , Gloria M González  2 , Rosa María Ponce  1
Affiliations

Mycetoma: experience of 482 cases in a single center in Mexico

Alexandro Bonifaz et al. PLoS Negl Trop Dis. .

Abstract

Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013). A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11%) were actinomycetomas and 38 cases (7.88%) were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years). The main affected localization was lower and upper limbs (70.74% and 14.52% respectively). Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported). The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%). Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21%) and Actinomadura madurae (8.7%); meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii) were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Age distribution of the mycetoma patients.
Figure 2
Figure 2. Geographical location of the five states with the higher incidence of mycetoma in Mexico.
Figure 3
Figure 3. a) Foot mycetoma due to A. madurae.
b) Back mycetoma with multiple sinuses caused by N. brasiliensis. c) Extensive mycetoma in an adolescent due to N. brasiliensis. d) Exophytic or tumoral mycetoma caused by Fusarium solani complex.
See this image and copyright information in PMC

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