A surgeon's trial success of curing pedal eumycetoma
Mitchell, James
Mitchell, James
Abstract
Mycetoma is a chronic infection of underlying fungal (eumycetoma) or bacterial (actinomycetoma) origin. It is characterised by a clinical triad of tumour-like swelling, actively draining sinuses and macroscopic grains of characteristic colours.
We the case of a 66-year-old woman on immunosuppressive therapy presenting with eumycetoma of the foot (Madura foot). The fungal organism cultured was Acrophialophora fusispora.
This case was managed with a combination of extensive surgical debridement, and packing with calcium sulfate (Stimulan) beads impregnated with vancomycin and voriconazole. As far as the authors are aware, this is a novel adjunct to the surgical treatment of deep fungal infection in the foot.
Eumycetoma treated with surgery and oral antifungal therapy leads to cure rates of 25%–35%. This novel treatment seems to bear further investigation for the potential to improve cure rates. At 8 months follow-up, our patient appears to be making good progress with no current signs of recurrence.
MIDER Authors
Affiliations
Citations
Altmetric:
Date
2023-07
Type
Article
Subject
Collections
Citation
Choudhry, B., Mitchell, J. and Milner, S. (2023) ‘A surgeon’s trial success of curing pedal eumycetoma’, BMJ case reports, 16(7)