Table 1 Characteristic features of eumycetoma and actinomycetoma
From: Mycetoma: a clinical dilemma in resource limited settings
Characteristics | Eumycetoma | Actinomycetoma |
|---|---|---|
Causative agents | Fungi [32] | Bacteria [32] |
Geography | Common in Africa and India [1] | Common in Latin America [1] |
Occupation | Field workers [1] | Field workers [1] |
Age group | Common in 20–40 years [1] | Common in 20–50 years [1] |
Anatomical parts affected | Usually hand, feet and other parts of arms and legs [1] | Usually chest, abdomen and head [1] |
Course of progression | Slow [64] | More rapid and inflammatory [64] |
Sinus (number, morphology) | Few, proliferative, protuberant [1] | Many, depressed, flat [1] |
Fistula | Few [32] | Many [32] |
Bone invasion | Delayed [32] | Rapid [32] |
Bone cavities on radiograph | Fewer but larger with clear margins [32] | Numerous, small with unclear margins [32] |
Lymphatic spread | Occassional [1] | Frequent [1] |
Veins proximal to lesion | Commonly dilated | Seldom dilated |
Grains size | Larger (0.5–2 mm) [64] | Smaller (20–100 μm) [64] |
Grain texture | Coarse [64] | Fine [64] |
Pigment | Melanin [64] | Absent [64] |
Hyphae [64] | Septate (4–5 μm thick) | Fine, branching filaments (< 1 μm) |
Acid fast staining | Negative [64] | Weakly acid fast (e.g. Nocardia) |
Masson–Fontana silver staining | Positive [64] | Negative [64] |
PAS staining | Positive [64] | Negative [64] |
GMS staining | Positive [64] | Positive [64] |
B and B staining | Negative [64] | Gram positive [64] |
Ultrasound features | Hyperechogenic [1] | Less echogenic [1] |
Treatment | Drugs (antifungal) + surgery [1] | Drugs (antibiotics) [1] |