Scintigraphic evaluation of mycetoma.

Mycetoma is a rare deep mycosis caused by certain fungi. Clinical findings include enlargement and tumefaction of the affected region accompanied by grains coming out of the lesions. The feet are the most frequently affected area. Four patients have been studied who presented with mycetoma of the feet. Gallium scintigraphy was always abnormal in the affected areas and bone scintigraphy was abnormal in three of the four patients. The patient who had a normal bone study had received effective treatment (7 years). In the other patients the results were poor. Scintigraphic findings seem to be similar to those noted in cases of acute osteomyelitis associated with cellulitis, despite long-term therapy. Bone and gallium studies may be of possible value for therapy follow-up in cases of mycetoma.

[Black-grain eumycetoma due to Madurella grisea. A report of 2 cases]. / Eumicetoma de grãos pretos por Madurella grisea. Registro de dois casos.

Two cases of black grains eumycotic mycetoma, occurring on a foot, are reported. Both proceeded from the state of Bahia (Brazil), and in both the etiologic agent was Madurella grisea Mackinnon et al., 1949. The grains structure as well as the micromorphologic characteristics of the fungus in saprophytic life were studied. It is the author's belief that these observations correspond to the 7th and 8th cases reported in the Brazilian medical literature. The authors do consider the following Madurella species as nomen dubium or nomina confusa: M. ramiroi, M. oswaldoi, M. bovoi, M. tozeuri, M. mansonii, M. brumpti, M. reynieri, M. americana, M. lackawanna e M. ikedae and the same for Rubromadurella mycetomi. The only valid species must be Madurella mycetomatis McGinnis, 1980 (= Madurella mycetomi Brumpt, 1905) and Madurella grisea Mackinnon et al., 1949. Treatment with itraconazole in both reported cases, for a 3 month duration, did not produce any regression of the lesions, the clinical improvement being meager.