infectious diseases
Mycetoma
Symptoms and Signs of Mycetoma
The initial lesion of mycetoma may be a papule, a fixed subcutaneous nodule, a vesicle with an indurated base, or a subcutaneous abscess that ruptures to form a fistula to the skin surface. Fibrosis is common in and around early lesions. Tenderness is minimal or absent unless acute suppurative bacterial superinfection is present. Infection progresses slowly over months or years, gradually extending to and destroying contiguous muscles, tendons, fascia, and bones. Neither systemic dissemination nor symptoms and signs suggesting generalized infection occur. Eventually, muscle wasting, deformity, and tissue destruction prevent use of affected limbs. In advanced infections, involved extremities appear grotesquely swollen, forming a club-shaped mass of cystic areas. The multiple draining and intercommunicating sinus tracts and fistulas in these areas discharge thick or serosanguineous exudates containing characteristic grains, which may be white or black. This image shows multiple, infiltrated nodules on the foot of a patient with mycetoma. © Springer Science+Business Media © Springer Science+Business Media This image shows multiple subcutaneous nodules and rupture to the skin surface. © Springer Science+Business Media This photo shows chronic, nonhealing wounds with recurring episodes of drainage and ulceration (top) and advanced destruction of the entire bony architecture of the foot (bottom). © Springer Science+Business Media 