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Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature
BACKGROUND: Mycetoma is a chronic granulomatous infection involving cutaneous and subcutaneous tissues. It is endemic in tropical and subtropical areas, but sporadic cases have been reported also in countries of temperate climate. The purpose of this paper is to review the cases of mycetoma in Europ...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070928/ https://www.ncbi.nlm.nih.gov/pubmed/24963778 http://dx.doi.org/10.1371/journal.pone.0100590 |
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author | Buonfrate, Dora Gobbi, Federico Angheben, Andrea Marocco, Stefania Farina, Claudio Van Den Ende, Jef Bisoffi, Zeno |
author_facet | Buonfrate, Dora Gobbi, Federico Angheben, Andrea Marocco, Stefania Farina, Claudio Van Den Ende, Jef Bisoffi, Zeno |
author_sort | Buonfrate, Dora |
collection | PubMed |
description | BACKGROUND: Mycetoma is a chronic granulomatous infection involving cutaneous and subcutaneous tissues. It is endemic in tropical and subtropical areas, but sporadic cases have been reported also in countries of temperate climate. The purpose of this paper is to review the cases of mycetoma in European subjects (and presumably acquired in Europe), to give an insight in the main factors associated with this condition, and to describe two previously unpublished cases observed at our Centre. METHODS AND FINDINGS: PubMed was systematically searched for case reports and case series of mycetoma in Europeans reported between 1980 and 2014, using specific search strategies. Two further cases diagnosed by the authors are described. Forty-two cases were collected. Eleven cases were caused by Scedosporium apiospermium, mainly in immunosuppressed patients from Bulgaria, Germany, the Netherlands, Portugal, Slovenia, Spain and the United Kingdom. Excluding all patients with immunosuppression, 29 cases remain. Most of them were reported from Bulgaria and in Albanian patients (all diagnosed outside Albania). In the Bulgarian case series many different micro-organisms, both bacteria and fungi, were isolated, while all the 5 cases from Albania were caused by Actinomadura spp. Other countries reporting cases were Greece, Italy and Turkey. In general, Actinomadura spp is the most frequent causative agent isolated, followed by Nocardia spp and Madurella mycetomatis. The foot was the most reported site involved. Most patients were medically treated, but unfortunately a long-term follow up (at least one year) was available only in a few cases. CONCLUSIONS: Our review and our own cases suggest that Europeans without travel history can be affected by Madura foot. The lack of a surveillance system is likely to cause an underreporting of cases. Moreover, the unfamiliarity of Western doctors with this peculiar infection may cause a mismanagement, including unnecessary amputations. |
format | Online Article Text |
id | pubmed-4070928 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-40709282014-06-27 Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature Buonfrate, Dora Gobbi, Federico Angheben, Andrea Marocco, Stefania Farina, Claudio Van Den Ende, Jef Bisoffi, Zeno PLoS One Research Article BACKGROUND: Mycetoma is a chronic granulomatous infection involving cutaneous and subcutaneous tissues. It is endemic in tropical and subtropical areas, but sporadic cases have been reported also in countries of temperate climate. The purpose of this paper is to review the cases of mycetoma in European subjects (and presumably acquired in Europe), to give an insight in the main factors associated with this condition, and to describe two previously unpublished cases observed at our Centre. METHODS AND FINDINGS: PubMed was systematically searched for case reports and case series of mycetoma in Europeans reported between 1980 and 2014, using specific search strategies. Two further cases diagnosed by the authors are described. Forty-two cases were collected. Eleven cases were caused by Scedosporium apiospermium, mainly in immunosuppressed patients from Bulgaria, Germany, the Netherlands, Portugal, Slovenia, Spain and the United Kingdom. Excluding all patients with immunosuppression, 29 cases remain. Most of them were reported from Bulgaria and in Albanian patients (all diagnosed outside Albania). In the Bulgarian case series many different micro-organisms, both bacteria and fungi, were isolated, while all the 5 cases from Albania were caused by Actinomadura spp. Other countries reporting cases were Greece, Italy and Turkey. In general, Actinomadura spp is the most frequent causative agent isolated, followed by Nocardia spp and Madurella mycetomatis. The foot was the most reported site involved. Most patients were medically treated, but unfortunately a long-term follow up (at least one year) was available only in a few cases. CONCLUSIONS: Our review and our own cases suggest that Europeans without travel history can be affected by Madura foot. The lack of a surveillance system is likely to cause an underreporting of cases. Moreover, the unfamiliarity of Western doctors with this peculiar infection may cause a mismanagement, including unnecessary amputations. Public Library of Science 2014-06-25 /pmc/articles/PMC4070928/ /pubmed/24963778 http://dx.doi.org/10.1371/journal.pone.0100590 Text en © 2014 Buonfrate et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Buonfrate, Dora Gobbi, Federico Angheben, Andrea Marocco, Stefania Farina, Claudio Van Den Ende, Jef Bisoffi, Zeno Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature |
title | Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature |
title_full | Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature |
title_fullStr | Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature |
title_full_unstemmed | Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature |
title_short | Autochthonous Cases of Mycetoma in Europe: Report of Two Cases and Review of Literature |
title_sort | autochthonous cases of mycetoma in europe: report of two cases and review of literature |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070928/ https://www.ncbi.nlm.nih.gov/pubmed/24963778 http://dx.doi.org/10.1371/journal.pone.0100590 |
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