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Head and neck mycetoma: the mycetoma research centre experience.

Fahal A, Mahgoub el S, El Hassan AM, Jacoub AO, Hassan D - PLoS Negl Trop Dis (2015)

Bottom Line: There was no obvious history of local trauma, familial tendency or other predisposing factor identified in this group of patients.The treatment outcome was rather poor and characterised by low cure rate, poor outcome and high follows-up dropout.Such a gloomy outcome calls for structured and objective health education programs.

View Article: PubMed Central - PubMed

Affiliation: The Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.

ABSTRACT
Mycetoma is a unique neglected tropical disease which is endemic in what is known as the "mycetoma belt". The disease has many devastating impacts on patients and communities in endemic area and is characterised by massive deformity, destruction and disability. Mycetoma is commonly seen in the foot and hand and less frequent in other parts of the body. Mycetoma of the head and neck is a rarity and is associated with high morbidity and even mortality if not treated early. In this communication we report on 49 patients with head and neck mycetoma followed up at the Mycetoma Research Centre in Khartoum. Most of the reported patients had actinomycetoma and the majority were young adult males from mycetoma endemic areas in the Sudan. Most of them were students, farmers and workers. Prior to presentation the majority had long disease duration and the cause was multifactorial. Advanced disease with massive lesion, deformity and disability was the common presentation. There was no obvious history of local trauma, familial tendency or other predisposing factor identified in this group of patients. MRI and CT scan were the most accurate diagnostic tools to determine the disease extent. The treatment outcome was rather poor and characterised by low cure rate, poor outcome and high follows-up dropout. Such a gloomy outcome calls for structured and objective health education programs.

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Related in: MedlinePlus

A: Showing massive head actinomycetoma with severe bilateral proptosis.This patient had vision loss in the right eye, and loss of hearing in both ears due massive intra-cranial involvement. B: Skull CT scan showing massive intracranial actinomycetoma involvement with bones destruction. The patient agreed to show his photos for publication purpose.
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pntd.0003587.g001: A: Showing massive head actinomycetoma with severe bilateral proptosis.This patient had vision loss in the right eye, and loss of hearing in both ears due massive intra-cranial involvement. B: Skull CT scan showing massive intracranial actinomycetoma involvement with bones destruction. The patient agreed to show his photos for publication purpose.

Mentions: Different parts of the head and neck were involved which included the frontal (n = 12), occipital (n = 5), parietal (n = 1) and temporal region (n = 1). Multiple skull bones involvement was documented in 12 patients, (Table 1). Five patients had combined frontal and parietal and/ or temporal bone involvement. Two patients had combined occipito-temporo-parietal bones affection. One patient had massive sphenoid, ethmoid, maxillary, nasal bones, anterior cranial fossa, temporal, frontal and occipital bones and supra-orbital areas. One patient had infra-temporal fossa mycetoma extending to the nasopharynx involvement. Two patients had base of the skull and occipital mycetoma with cervical region extension. The orbit was involved in two patients. The upper eye lid, buccal cavity and cheek were affected in one each. Ten patients (20%) had cervical mycetoma. Four patients (4%) had intracranial lesions (Figs. 1, 2, 3).


Head and neck mycetoma: the mycetoma research centre experience.

Fahal A, Mahgoub el S, El Hassan AM, Jacoub AO, Hassan D - PLoS Negl Trop Dis (2015)

A: Showing massive head actinomycetoma with severe bilateral proptosis.This patient had vision loss in the right eye, and loss of hearing in both ears due massive intra-cranial involvement. B: Skull CT scan showing massive intracranial actinomycetoma involvement with bones destruction. The patient agreed to show his photos for publication purpose.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4359145&req=5

pntd.0003587.g001: A: Showing massive head actinomycetoma with severe bilateral proptosis.This patient had vision loss in the right eye, and loss of hearing in both ears due massive intra-cranial involvement. B: Skull CT scan showing massive intracranial actinomycetoma involvement with bones destruction. The patient agreed to show his photos for publication purpose.
Mentions: Different parts of the head and neck were involved which included the frontal (n = 12), occipital (n = 5), parietal (n = 1) and temporal region (n = 1). Multiple skull bones involvement was documented in 12 patients, (Table 1). Five patients had combined frontal and parietal and/ or temporal bone involvement. Two patients had combined occipito-temporo-parietal bones affection. One patient had massive sphenoid, ethmoid, maxillary, nasal bones, anterior cranial fossa, temporal, frontal and occipital bones and supra-orbital areas. One patient had infra-temporal fossa mycetoma extending to the nasopharynx involvement. Two patients had base of the skull and occipital mycetoma with cervical region extension. The orbit was involved in two patients. The upper eye lid, buccal cavity and cheek were affected in one each. Ten patients (20%) had cervical mycetoma. Four patients (4%) had intracranial lesions (Figs. 1, 2, 3).

Bottom Line: There was no obvious history of local trauma, familial tendency or other predisposing factor identified in this group of patients.The treatment outcome was rather poor and characterised by low cure rate, poor outcome and high follows-up dropout.Such a gloomy outcome calls for structured and objective health education programs.

View Article: PubMed Central - PubMed

Affiliation: The Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.

ABSTRACT
Mycetoma is a unique neglected tropical disease which is endemic in what is known as the "mycetoma belt". The disease has many devastating impacts on patients and communities in endemic area and is characterised by massive deformity, destruction and disability. Mycetoma is commonly seen in the foot and hand and less frequent in other parts of the body. Mycetoma of the head and neck is a rarity and is associated with high morbidity and even mortality if not treated early. In this communication we report on 49 patients with head and neck mycetoma followed up at the Mycetoma Research Centre in Khartoum. Most of the reported patients had actinomycetoma and the majority were young adult males from mycetoma endemic areas in the Sudan. Most of them were students, farmers and workers. Prior to presentation the majority had long disease duration and the cause was multifactorial. Advanced disease with massive lesion, deformity and disability was the common presentation. There was no obvious history of local trauma, familial tendency or other predisposing factor identified in this group of patients. MRI and CT scan were the most accurate diagnostic tools to determine the disease extent. The treatment outcome was rather poor and characterised by low cure rate, poor outcome and high follows-up dropout. Such a gloomy outcome calls for structured and objective health education programs.

Show MeSH
Related in: MedlinePlus