@article{97253, keywords = {Infectious Diseases, Public Health, Environmental and Occupational Health, General Medicine, Parasitology}, author = {Musa EA and Abdoon IH and Bakhiet SM and Osman B and Abdalla SA and Fahal AH}, title = {Mycetoma management and clinical outcomes: the Mycetoma Research Center experience}, abstract = {

Background Mycetoma is a chronic granulomatous inflammatory disease that affects the cutaneous and subcutaneous tissues, leading to gruesome complications if not treated early. As a neglected disease, it has received scant attention in developing curable drugs. Mycetoma treatment is still based on expert opinions in the absence of guidelines. Methods This descriptive, cross-sectional, hospital-based study aimed to determine and assess the disease treatment outcomes observed at Mycetoma Research Center, Sudan. Results In this study, 75% of patients had eumycetoma, all of whom were treated with itraconazole and 37.4% underwent surgical excision, while 25% of the patients had actinomycetoma, 99.2% of whom were treated with a combination of cotrimoxazole and amoxicillin-clavulanate. The cure rate was 12.7% and 14.3% for patients with eumycetoma and actinomycetoma, respectively. Only 6.1% of eumycetoma patients underwent amputation. Remarkably, no patient with actinomycetoma underwent an amputation. Small lesions (OR=10.09, p<0.001) and good follow-up (OR=6.81, p=0.002) were positive predictors of complete cure. In terms of amputation, history of surgical recurrence at presentation (OR=3.67, p=0.020) and presence of grains (OR=7.13, p=0.012) were positive predictors, whereas small lesions were negative predictors (OR=0.06, p=0.009). Conclusions Treatment of mycetoma was suboptimal, with a low cure rate despite a long treatment duration. Complete cure has a significant association with small lesions and good follow-up.

}, year = {2022}, journal = {Transactions of The Royal Society of Tropical Medicine and Hygiene}, publisher = {Oxford University Press (OUP)}, issn = {0035-9203, 1878-3503}, doi = {10.1093/trstmh/trac069}, language = {eng}, }