Mycetoma是一种严重的,破坏性,毁容慢性肉芽肿性炎症性疾病,影响扩散到皮肤的皮下组织,深层组织和骨骼。这种疾病主要影响四肢,很少报道脑外肌瘤。报告的脑外肿瘤的特点是发病率和死亡率高。本通讯报告了在Mycetoma研究中心(MRC)看到和治疗的420例髓外肌瘤患者,喀土穆大学,1991年1月至2021年12月。在这个描述性的,横截面,以医院为基础的研究,在研究期间,我们对所有确诊为细菌瘤的患者的电子记录进行了仔细和细致的审查.本研究包括确诊的脑外肌瘤患者。该研究包括420例脑外肌瘤患者,298例(70.7%)患有细菌瘤,122例(29.3%)有放线菌瘤。男性343例(81.7%),女性77例(18.3%),男女比例为4:1。他们的年龄在1.5到95岁之间,中位数为28岁。大多数患者是学生和农民。大多数患者来自ElGezira,北科尔多凡州,和白尼罗河州。21%的菌丝瘤疼痛,11.5%的患者有肌瘤家族史。臀部(37.9%)和头颈部(16.9%)受累最多。不太常见的受影响的部位是躯干和背部(12%),腹壁和胸壁(4.5%)和腰部(1%)。突出的临床表现发现是多个鼻窦排出颗粒(55%),大量肿胀(46%),和淋巴结肿大(11.5%)。较少见的临床发现是局部多汗症(5.3%)和靠近肌瘤病变的扩张曲折静脉(0.5%)。研究表明,204例患者(48.6%)在药物治疗后病变大小减小和鼻窦愈合方面有临床改善。66例患者(15.7%)无明显改善。尽管有44例患者(10.5%)接受了治疗,但病变仍在继续发展。在研究中,118例患者定期随访,在这个群体中,25例(21.1%)的大肠杆菌瘤患者和23例(19.4%)的放线菌瘤患者被证实治愈.Eumycetoma患者的术后复发率为40%,死亡率为1%。治疗结果不令人满意,以低治愈率为特征,高复发率(40%)和随访脱落率(57%)。这强调了早期发现和管理病例的重要性,客观的健康教育计划和全面的患者咨询,以敦促人们尽早寻求治疗并减少辍学。
Mycetoma is a serious, destructive, disfiguring chronic granulomatous inflammatory disease affecting the subcutaneous tissues that spread to involve the skin, deep tissues and bone. The disease predominately affects the limbs, and extrapedal
mycetoma is rarely reported. The reported extrapedal ones are characterised by high morbidity and mortality. This communication reports on 420 patients with extrapedal
mycetoma seen and managed at the
Mycetoma Research Centre (MRC), University of Khartoum, between January 1991 and December 2021. In this descriptive, cross-sectional, hospital-based study, the electronic records of all mycetoma-confirmed patients seen during the study period were carefully and meticulously reviewed. The confirmed patients with extrapedal
mycetoma were included in this study. The study included 420 patients with extrapedal mycetoma, 298 (70.7%) had eumycetoma, and 122 (29.3%) had actinomycetoma. There were 343 male patients (81.7%) and 77 (18.3%) females, with a male-to-female ratio of 4:1. Their ages ranged between 1.5 and 95 years, with a median of 28 years. Most of the patients were students and farmers. The majority of patients were from El Gezira, North Kordofan, and the White Nile States.
Mycetoma was painful in 21%, and a family history of
mycetoma was recorded in 11.5% of patients. The buttocks (37.9%) and head and neck (16.9%) were affected most. Less frequently affected sites were the trunk and back (12%) each, abdominal and chest walls (4.5%) each and loin (1%). The prominent clinical presentation findings were multiple sinuses discharging grains (55%), massive swellings (46%), and lymphadenopathy (11.5%). Less commonly observed clinical findings were local hyperhidrosis (5.3%) and dilated tortuous veins close to mycetoma lesions (0.5%). The study showed that 204 patients (48.6%) had clinical improvement in terms of decreased lesion size and healing of sinuses following medical therapy. Sixty-six patients (15.7%) had no noticeable improvement. The lesion continued progressing despite treatment in 44 patients (10.5%). In the study, 118 patients were on regular follow-up, and in this group, a cure was documented in 25 patients (21.1%) with eumycetoma and 23 (19.4%) with actinomycetoma. Post-operative recurrence among eumycetoma patients was 40%, with a 1% mortality rate. The treatment outcome was unsatisfactory, characterised by a low cure rate, high recurrence (40%) and follow-up dropout (57%) rates. This emphasises the importance of early case detection and management, objective health education programmes and thorough patient counselling to urge people to seek treatment early and reduce dropouts.