Mycetoma - causes, symptoms, diagnostics, treatment, prevention
- 30 Sep 18:15
- Disease Of The Skin
Mycetoma( second name of the pathology - Madur's foot) is a chronic purulent-fistulous inflammatory disease that affects soft tissues. The mycelium of the foot most often develops. The disease is caused by several species of fungi, as well as bacteria belonging to theNocardia family. To date, there are more than 50 types of fungi that can cause mytsetoma development.
Mycetoma acquired its second name due to the fact that one of the first detailed descriptions of the disease was created on the basis of the study of patients living in the Indian city of Madura.
Mycetoma is common in countries with subtropical and tropical climate. Especially often mytsetoma occurs in the inhabitants of rural areas. Fungal form of the disease is called eumicoticheskaya mytsetoma, it is more common than the bacterial species of the Madur foot.
Sporadic cases of mycetomism are possible anywhere in the world, regardless of the climate. Most often, the Madur foot is diagnosed in men in the age range of 20-50 years.
- 1 Causes of
- 2 disease clinical picture
- Diagnostic Methods 4
- treatment 4.1 Treatment with folk remedies
- 5 Prevention and prognosis
- 6 Photo
disease Mycetoma develops as a result of infection with fungi or bacteria. Microorganisms that contribute to the formation of the Madur foot, differ in geographical distribution and nature.
The pathogens of mycetoms are found in the soil and on the surface of plants, their penetration into the body is due to the presence of minor injuries on the surface of the skin. Infection with mytsetoma from a sick person does not occur.
Clinical picture of
Mycetoma is often diagnosed in people who are involved with agriculture, as well as in nomads and Bedouins. The way of life of these people involves walking on the soil barefoot or in open shoes, which leads to damage to the skin of the spiny plants and promotes the penetration of pathogens and the development of the disease.
Most commonly, mytsetoma affects the foot, for unknown reasons, in most patients the pathological process is observed in the left foot. The disease is characterized by tumor-like consolidation of the soft tissues of the foot, in which there are numerous fistula moves. Such pathological changes of the foot, most often, are painless, therefore, not all patients with myetheomy turn to the doctor.
Sometimes mytsetoma affects other parts of the body. When working with the ground mytsetoma can develop hand brushes. In the case of infection when sitting or lying on the ground in the pathological process can be involved in the legs, hips, buttocks. When lesions of myetoma of the head tissue, as a rule, the infection spreads from the back of the neck.
Up to the early symptoms of mytsetomes include the appearance of small painless papules. At the initial stage of the disease, they appear on the back side of the foot and sole. Neoplasms with mycetomy progress rapidly, increasing in size. In the bacterial form of mytsetoma the process is more active than in a disease caused by fungi.
As mycetoms develop, the process captures an increasing amount of soft tissue, the foot becomes swollen, fistula moves are formed.
Former fistulas on the foot over time get healed, but new ones are immediately formed. Thus, when long-term mycetium occurs in the tissues of the foot, you can observe a number of healed scars and newly created fistulas.
In the course of a long-term flow of mytsetoma can affect even deeper tissues, including bones. At this stage of the disease there is a generalized edema, but pain syndrome is manifested only in 15% of patients with mycetomy.
With the progression of mitosis, formation of tumor-like focal structures, areas of suppuration and old scars is observed. From fistulous passages at mytsetome there is an isolation of manure with grain formations - drosses of fungi.
With mycetomy infection, the infection never spreads to the blood stream, but can progress through the lymphatic vessels. In this case, patients with Madur's foot have inflammation, and sometimes suppuration of regional lymph nodes.
With osteomyelitic cavities with a periosteal growth of bone tissue, patients develop bone marrow micence. Sometimes osteoporosis develops with mycetium.
Diagnosis of the Madur Foot is based on the study of the clinical picture of the disease. To confirm the diagnosis, the presence of three characteristic symptoms of mytzoma is required:
Grain in purulent discharge at mycelium may have a size of 0.2 to 3 mm in diameter. The color of the grains is determined by the type of pathogen mytsetoma, they can be red, black, pink, yellow, white.
It is not always possible to consider the grain by simply placing a fist on the slide. In some cases, for secretion of druze, their fixation in paraffin is necessary.
To adequately isolate druze and determine the pathogen mytsetomy apply coloration of the material, using different techniques.
For a more accurate determination of the pathogen mytsetoma produced crop drusus. Before conducting this analysis, it is necessary to free the grain from the presence of foreign bacteria. This is done by washing the grains in a solution of alcohol( 70%), then it is necessary to rinse the material repeatedly in a physiological solution( sterile).
To obtain the material necessary for histological and cultural research, a deep wedge-shaped biopsy of macithomas is performed. The study of biopsies obtained from the sites of defeat at the Madur foot, allows you to obtain more accurate information about the pathogen than the analysis of fecal manure from the feces, as the latter often contains a large number of superficial microorganisms.
The success of the treatment of mycetium is determined by the stage of the disease on which the therapy is initiated. The best results in the treatment of the Madur foot can be achieved with early diagnosis of the disease.
Typically, mycetium is treated by conservative methods, but sometimes it is necessary to resort to local surgical intervention. Radical operations, consisting of amputation of the affected mycelium of the foot, try not to hold.
The success of mycelium therapy is based on the identification of the pathogen and the determination of the sensitivity of microorganisms to drugs.
When eumicotious( fungus-induced) mytsetome is prescribed, the antifungal effects are fluconazole, itraconazole, ketoconazole. If the Madur foot was formed due to infection with bacteria, sulfanilamide agents, dapsone, antibiotics are used.
If mycetoma conservative therapy does not have a noticeable effect on surgical procedures. Typically, an autopsy and tumor is performed. In exceptional cases, in case of severe illness, they resort to amputation of the affected mycelium foot.
Miacetum requires long-term treatment. As a rule, at least 10 months of conservative therapy is required to get rid of the Madur foot. Such prolonged use of medicinal products can cause side effects, so during the treatment of mycetoms, regular clinical examinations, liver function tests should be performed. If necessary, replacement of drugs for the treatment of mycithomas, selected supportive therapy.
Treatment of folk remedies
Treatment of mycetoms should be conducted under the guidance of a physician. Treating herbs can be used as a supplement to the basic therapy of the Madur foot.
To increase the immunity and increase the effectiveness of treatment of mytsetoma it is recommended to take decoctions of such herbs as sweet, mushroom, dill, veronica. Broths can be prepared from a mixture of these plants or from one component. Take a third of the glass three times a day for a long time( at least a year).
For the quickest possible disposal of mytsetom it is necessary to mix the leaves of burdock, plantain, grass, celandine and wormwood. All grasses are taken in equal quantities. Every night, a spoon of mixture should be brushed with a glass of boiling water in a thermos. For the treatment of the Madura foot, drink the infusion on an empty stomach daily. Course of treatment for mycetoma - 12 months.
Ointment can be prepared for local treatment. It is necessary to take 100 grams of rural sweet unsalted butter. Put the melted fat in a small jar, then put the whole egg in the shell. Pour half a glass of vinegar into the same jar. Hold the container in the refrigerator until the shell completely dissolves. The finished ointment is well mixed and applied to the affected skin with mytsetom twice a day.
Prophylaxis and Forecast
For mitosis, the prognosis depends on the localization of the process and its prevalence. The disease proceeds chronically, during 10-20 years. The threat to the life of a patient with a Madur's foot may arise in the development of mycelium complications, in which internal organs are affected, and sepsis develops. To serious complications mytsetomy also includes loss of limb function, which leads to its amputation.
The prophylaxis of the development of the Madur foot is to carry out measures on the sanitary education of the population. It is necessary to protect the feet from minor injuries. In the event of scratches and abrasions on the feet, it is necessary to treat damage in a timely manner with disinfectants.