A rare case eumycetoma: Successful treatment with itraconazole
Abstract
Eumysetoma is a chronic infectious disease characterized by an enlarged subcutaneous mass, often caused by the fungus Madurella mycetomatis. Eumycetoma can affect all age groups, but often occurs in young people between 20 and 40 years, in children rarely 3-4.5% but can be up to 30% of cases, dominant in males with a ratio of 4:1, mainly working agricultural activities. Treatment of eumycetoma with medication antifungal group Triazola (Itraconazole) and surgery are the therapy of choice. We report a case of eumycetoma treated with itraconazole. A 57-year-old man with complaints of progressive chronic wounds. Dermatological status showed multiple nodules, there were sinuses with discharge and grain on the feet. Histopathological examination revealed suppurative granuloma and Splendore-Hoeppli phenomenon in the dermis layer. The patient was diagnosed with eumycetoma and treated with itraconazole 2x200mg. Administration of itraconazole 2x400 therapy in eumycetoma patients is effective and provides clinical improvement.References
Lim W, Melse Y, Konings M, Duong HP, Eadie K, Perry B, et al. Addressing the most neglected diseases through an open research model: The discovery of fenarimol as novel drug candidates for eumycetoma. PLoS Negl Trop Dis. 2018;12(4):1–23.
Tazi S, Konzi KM, Chachi EM, Lyagoubi M, Aoufi S. ScienceDirect Epidemiological profile of eumycetomas in Rabat, Morocco, over 40 years. J Mycol Med. 2019;100902. Available from:https://doi.org/10.1016/j.mycmed.2019100902
Hey RJ. Deep Fungal Infections. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, Mcmichael AJ, et al., editors. Fitzpatrick's Dermatology. 9th ed. New York: McGraw-Hill Education; 2019. p. 2969–71.
Arenas R, Vega-mémije ME, Rangel-gamboa L. Eumycetoma : present status and perspective. Gac Med Mex. 2017;763–72.
Estrada-castañ R, Estrada-ch G. Diagnosis and Management of Fungal Neglected Tropical Diseases In Community Settings — Mycetoma and Sporotrichosis. Trop Med Infect Dis. 2019;4(81):1–9.
Elkheir LYM, Haroun R, Awadalla M, Id M, Id HF. Madurella mycetomatis causing eumycetoma medical treatment: The challenges and prospects. PLoS Negl Trop Dis. 2020;14(8):1–17.
Zijlstra EE, Sande WWJ Van De, Welsh O, Mahgoub ES, Goodfellow M, Fahal AH. Mycetoma: a unique neglected tropical disease. Lancet Infect Dis. 2016;16(1):100–12. Available from: http://dx.doi.org/10.1016/S1473-3099(15)00359-X
Yahya S, Widaty S, Miranda E, Bramono K. Subcutaneous mycosis at the Department of Dermatology and Venereology dr. Cipto Mangunkusumo National Hospital. J Gen Pro DVI. 2016;1(2):36–43.
Patterson JW. Mycetoma and Morphologically Similar Conditions. In: James W. Patterson, editor. Weedon's Skin Pathology. 4th ed. London: Churchill Livingstone Elsevier; 2016. p. 707–10.
Relhan V, Mahajan K, Agarwal P, Garg VK. Mycetoma: An Update. Indian J Dermatol. 2017;62(4):332.
Elewski BE, Hughey LC, Hunt KM, Hay RJ. Fungal Diseases. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4th ed. New York: Elsevier Limited; 2018. p. 1348–9.
