Mycetoma is a unique neglected tropical disease. It is a morbid chronic progressive inflammatory condition caused by certain fungi (eumycetoma) or bacteria (actinomycetoma). It is characterised by devastating distortions, disabilities, high morbidity and it has various negative impacts in term of health and socio-economically on patients, communities and health authorities. Young adult patients are affected most, but no age is immune. It is more frequently reported in farmers, shepherds and workers of low socio-economic status. The triad of a painless subcutaneous mass, multiple sinuses and purulent or seropurulent discharge that contains grains is pathognomonic of mycetoma. The mass usually spread to involve the skin and the deep structures, resulting in destruction, deformity and loss of function, and occasionally it can be fatal. The limbs are the most frequently affected sites, and that is seen in more than 80% of patients. Mycetoma patients tend to present late with massive disease due to multifactorial factors.
The current diagnostic tools for mycetoma are varied, and that include imaging, molecular and histopathological techniques, serodiagnostic tests, as well as the classical grain culture. It is interesting to note, most of these investigations are not available in mycetoma endemic area.
Presently, it is quite perplexing and challenging to treat patients with mycetoma, and the treatment outcome is unsatisfactory. It is characterised by low cure rate and high amputation and high recurrence rates. Currently, there are no control or prevention programmes for mycetoma.