Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

View all Images (36)

Mycetoma in Child
Other Resources UpToDate PubMed

Mycetoma in Child

Contributors: Zachary Skabelund MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Mycetoma, also referred to as Madura foot, eumycetoma, actinomycetoma, or exogenous actinomycosis, is a chronic, slowly progressive infection of the skin and subcutaneous tissue that develops after trauma and subsequent contamination with soil and/or vegetation. The causative organisms come from a variety of different genera of soil-dwelling bacteria and fungi. Causative organisms vary by region, with eumycetoma more common in Africa and India and actinomycetoma more common in Latin America.

Mycetoma is diagnosed most commonly in tropical, subtropical, and equatorial regions of the developing world. They are very rare in children. Risk factors include trauma (thorn puncture, mild abrasion), skin exposure to soil and/or vegetation (often due to farming, carrying crops, walking barefoot), male sex (likely due to increased occupational exposures and possibly hormonal differences), and immunodeficiency.

Mycetomas occur most commonly on the feet and lower extremities, where trauma and subsequent soil exposure are most likely. The rate of growth follows two patterns in children. The first pattern is the typical pattern in adults as well. After initial exposure to the pathologic organism, there is an incubation period of weeks to months before a papule or nodule develops. This slowly expands to form a tumor-like mass that develops subcutaneous abscesses. After about 6-12 months, fistulae appear, which exude purulent material and colored granules several millimeters in diameter. Granules represent large collections of bacteria or fungi, and their color varies depending on the organism present. The second pattern is much milder, with very slow growth of organisms even in long-standing disease. This leads to a more limited appearance, with one or a few sinuses and minimal surrounding tissue involvement. This form may be misdiagnosed as a pyogenic abscess or osteomyelitis.

Mycetoma is typically painless (pain implies secondary bacterial infection or osteomyelitis). Most infections remain localized and may cause significant local destruction. However, systemic spread may occur in immunocompromised children, with development of mycetomas in internal organs.

Related topic: Endogenous actinomycosis

Codes

ICD10CM:
B47.9 – Mycetoma, unspecified

SNOMEDCT:
410039003 – Mycetoma

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Reviewed:08/19/2019
Last Updated:08/19/2019
Copyright © 2022 VisualDx®. All rights reserved.
Mycetoma in Child
A medical illustration showing key findings of Mycetoma : Abscess, Chronic duration lasting years, Edema, Skin ulcer, History of trauma
Clinical image of Mycetoma - imageId=2698462. Click to open in gallery.  caption: 'A maroon plaque and an adjacent similar papule on the dorsal foot.'
A maroon plaque and an adjacent similar papule on the dorsal foot.
Copyright © 2022 VisualDx®. All rights reserved.