Eumycetoma-Eumycetoma & Actinomycetoma Pathogenesis & Diagnosis of Mycetoma

1. Eumycetoma
Dr Sumitha J
Associate Professor
JBAS College for Women,Chennai-18

2. Mycetoma
Mycetoma is a granulomatous foot infection acquired through
break or cut in the skin
They develop as painless masses beneath the skin
There are two types of Mycetoma based on the Causative agent-
Actinomycetoma(Bacteria) and Eumycetoma(Fungi)
It is a chronic and progressive destructive disease

3. Eumycetoma-Causative agents
Mycetoma Causative agent Grain Colour
Eumycetoma Madurella mycetomatis Black to Brown
Madurella grisea Black to brown
Falcifomispora senegaliensis Black
Neotestidina rosatti Yellow
Actinomycetoma Actinomadura madurae White
Actinomadurae pelletieri White
Nocardia Yellow

4. Difference between Actinomycetoma
and Eumycetoma
Characteristics Actinomycetoma Eumycetoma
Causative agent Bacteria Fungi
Gram’s Staining Gram Positive Gram Negative
Filament Septate
fi
ne branching Septate hyphae
Stain Better with Gram’s Stain Better with PAS

5. Difference between Actinomycetoma
and Eumycetoma
Characteristics Actinomycetoma Eumycetoma
Course of Infection Rapid Progression Slowly progressive
Grain Size Fine-20 to 100micrometer Coarse-0.5 to 2.0mm
Pigment on Histopathology Absent Melanin
Pathology
Clinical triad-1.Tumefaction
2.Draining sinuses
3.Discharging grains
Less In
fl
ammatory and less
destructive

6. Difference between Actinomycetoma
and Eumycetoma
Characteristics Actinomycetoma Eumycetoma
Culture SDA without cyclohgeximide
Drug of Choice
Dapsone
Sulfamethoxazole
Ketoconazole
Itraconazole
Pigment on Histopathology Absent Melanin
Pathology
Clinical triad-1.Tumefaction
2.Draining sinuses
3.Discharging grains
Less In
fl
ammatory and less
destructive

7. Mycetoma Pathogenesis
Transmitted from Soil through minor cuts/breaks in the skin
Microabscess
Slowly Progressive to Chronic granulomatous
Affects the Skin and Underlying tissues and continue to deform bone in severe
conditions

8. Mycetoma Clinical Presentation
Starts as a painless lump under the skin
Open Infection with Discharging Grains containing fungal spores
Thickening of skin and subcutaneous tissue
Lesion enlarges and become tumorous

9. Diagnosis
Clinical Presentation
Identification of Causative agents
Direct Microscopy of Grains
Culture of Organisms
Histological examination
Molecular Methods
Serology