Mycetoma

[1] While most cases of mycetoma occur in Sudan, Venezuela, Mexico, and India, its true prevalence and incidence are not well-known.

[2][3] It appears most frequently in rural areas, particularly in farmers and shepherds, who are often men between 20 and 40 years old earning the primary income for their families.

[4] Noteworthy, the diagnosis of mycetoma in non-endemic or low endemic areas as Europe and North Africa is challenging.

[5][6] Physicians in these areas are usually unfamiliar with the disease-specific manifestations and need to exercise extra vigilance regarding those patients who are at high risk of contracting mycetoma infections.

[10] Mycetoma is caused by common saprotrophs found in the soil and on thorny shrubs in semi-desert climates.

[10] Some common causative agents are:[11] Infection is caused as a result of localized skin trauma, such as stepping on a needle or wood splinter, or through a pre-existing wound.

[10] The first visible symptom of mycetoma is a typically painless swelling beneath the skin; over several years, this will grow to a nodule (lump).

[9] Affected people will experience massive swelling and hardening of the area, in addition to skin rupture and the formation of sinus tracts that discharge pus and grains filled with organisms.