PDF(Pubmed)
Abstract：
Mycetoma, commonly known as Madura foot, is a chronic and progressively destructive granulomatous disease caused by a fungus or anaerobic filamentous bacteria that affects the skin, subcutaneous tissue, and bones primarily in tropical and subtropical regions, with males between the ages of 20-40 having occupational exposure to outdoor environments, such as farming, predominantly affected. It is one of the World Health Organization\'s 17 \"neglected tropical diseases,\" characterized by a clinical trial of localized mass-like soft tissue injury with draining sinuses that discharge grains of infectious material. Here, we present a case report of a 40-year-old male with type 2 diabetes mellitus and a history of fieldwork, who exhibited early manifestations of mycetoma. Unlike the typical diffuse presentation seen in advanced cases, this patient\'s early presentation prompted diagnostic challenges due to its atypical nature. We highlight the importance of recognizing the early signs of mycetoma, particularly in individuals with predisposing factors such as diabetes and occupational exposure. Diagnostic dilemmas may arise, leading to potential misdiagnosis. Additionally, we emphasize the crucial role of biopsy in confirming the diagnosis, alongside imaging techniques, to facilitate timely intervention and management, thereby significantly impacting patient outcomes.
摘要：
Mycetoma,俗称马杜拉脚，是由影响皮肤的真菌或厌氧丝状细菌引起的慢性和进行性破坏性肉芽肿病，皮下组织,骨骼主要分布在热带和亚热带地区，20-40岁的男性职业暴露于户外环境，比如农业，主要受影响。它是世界卫生组织的17个“被忽视的热带病之一，“以局部肿块状软组织损伤的临床试验为特征，引流窦排出感染性物质颗粒。这里,我们提供了一个40岁的男性2型糖尿病和实地考察史的病例报告，表现为菌丝瘤的早期表现。与高级病例中典型的弥漫性表现不同，由于其非典型性，该患者的早期表现引发了诊断挑战。我们强调了认识到肌瘤早期症状的重要性，特别是在有糖尿病和职业暴露等诱发因素的个体中。诊断困境可能会出现，导致潜在的误诊。此外,我们强调活检在确认诊断中的关键作用，除了成像技术，为了便于及时干预和管理，从而显著影响患者的预后。
