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Year : 1967  |  Volume : 1  |  Issue : 2  |  Page : 172-179

Mycetoma



Correspondence Address:
L. N Mohapatra


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Mycetoma as the name suggests is a disease resulting in tumefactions and is characterized by the presence of mycotic granules (grains) in the infected tissue. Although it is a single clinical entity many different fungi are involved as aetiolgical agents. Carter (1860) had established the fungal origin of mycetoma more than a century ago and named the condition as “Madura foot”. It is a common practice to use the term maduromycosis as a synonym of madura foot or even as a synonym of mycetoma of any aetiology. The aetiological agents of mycetoma have been differentiated into (i) actinomycetes producing actinomycotic type of mycetoma and (ii) true fungi producing maduromycotic mycetoma or maduromycosis (Chalmers and Archibald 1916). The agents in the latter group again fall into two classes, ascomycetes (e.g. Allescheria boydii and Leptosphaeria senegalensis) and fungi imperfecti (e.g. Madurella, Phialophora, Cephalosporium, Glenospora, etc.). These fungi have nothing in common yet are capable of causing a very similar clinical picture-the “mycetomas”. The essential lesion in mycetoma is a non-specific granuloma, the suppurative center of which contains the granules. These granules have characteristics which permit differentiation of the aetiologic agents. Besides variation in the number, size, colour and shape the granules from a fresh specimen exhibit different staining characters and tissue reaction on histological examination. The study of the causative agent is completed by cultural characteristics and biochemical reactions. Unfortunately, often this is not possible due to fixation of the tissue in formalin or due to heavy secondary bacterial infection. But with reasonable care and experience it is possible to identify the causative agent in the tissue sections. The present paper deals with 25 case of mycetoma, in only 11 of which the aetiologic agent could be grown from the granules. However, aetiological diagnosis could be established in each case by a careful morphological and histological study of the granules.


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