Mycetoma, chromoblastomycosis and other deep mycoses

Mycetoma is characterized by a triad of painless ‎subcutaneous mass, multiple sinuses and discharge ‎containing grains. It usually ‎spreads to involve the skin, deep structures and bone resulting in ‎destruction, ‎deformity and loss of function, which may be fatal. ‎Mycetoma commonly ‎involves the extremities, back and gluteal region.‎

The treatment depends on the causative organisms for the bacterial causes; it is a long term antibiotics combination whereas for the fungal type, treatment requires combined antifungals drugs and surgery. The treatment is unsatisfactory, has many side effects, is expensive and not available in most endemic areas.

Mycetoma is a chronic, progressively destructive morbid inflammatory disease usually of the foot but any part of the body can be affected. Infection is most probably acquired by traumatic inoculation of certain fungi or ‎bacteria into the subcutaneous tissue. Mycetoma was described in the modern literature in 1694 but was first reported in the mid-19th century in the Indian town of Madura, and hence was initially called Madura foot.