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Mycetoma causative agents

Medical expert of the article

Prof. Francis Schleffer

Infectious disease specialist

Alexey Kryvenko, medical expert
Last reviewed: 06.07.2025

Pathogenesis

Epidemiology
Diagnostics
Treatment

Mycetoma (maduromycosis, malursky foot) is a chronic purulent-inflammatory process of the subcutaneous tissue and adjacent tissues. Mycetoma is caused by demacium fungi (eumycotic mycetoma) or actinomycetes (actinomycetes and cetomies) of the genera Actinomyces, Nocardia, Sireptomyces, Actimomadura. Among the fungi there are Pseudallescheria boydii, Aeremomum (Cephalosporium) Jidciforme, Madurella grisea, Phialophora cryanescem, Exophiala jrcmselmei, Scedosporium apiospermum, Leptosphaeria senegcdensis.

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Pathogenesis and symptoms of mycetoma

Infection occurs through damaged skin. Papules, deep nodes and abscesses gradually form. The destructive process affects fascia, muscles and bones. Fibrinous tissue develops. The lower limbs are most often affected. The foot swells and becomes deformed.

Epidemiology of mycetoma

Mycetoma pathogens live in soil and on plants. They are transmitted by contact. Airborne transmission with respiratory tract damage is also possible. Mycetoma is most often found in the tropics and subtropics.

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Microbiological diagnostics of mycetoma

In pus and biopsy treated with KOH solution, characteristic multi-colored grains (0.5-2 μm in diameter), septate hyphae and chlamydospores of fungi are revealed. Pseudallescheria boydii hyphae are difficult to distinguish from Aspergillus. In the presence of actinomycetes, druses and branching thin bacterial threads are visible. The sexual stage of P. boydii is accompanied by the formation of cleistothecia (100-200 μm), which rupture and release pale brown elliptical ascospores.

Treatment of mycetoma

Mycetoma is treated with itraconazole. Resection of affected tissue is possible.