Mycetoma in south Yemen

ABSTRACT

Mycetoma is one of the chronic,endemic diseases in many tropical and subtropical countries in the world. It is commonly distributed in the rural and high altitude areas. It is caused by true fungi or higher bacteria that gain access to the human body typically via a thorn prick or open wound. This is the first scientific study done about the disease in South Yemen [Hadramout]. To know the extent and to study Mycetoma in South Yemen [Hadramout]. All mycetoma cases who were managed in Ibn-Sinna hospital, Hadramout, from march 2004 to march 2008 were included in this descriptive study.The patients came from three governorates [Hadramout, Shabwa and Al-Mahra].The diagnosis depended on the clinical picture, radiological and histological investigations to confirm the disease and to identify the causative organism. 16 patients were studied in this report, aged between 20 -59 years, their mean age was 34 years. Male to female ratio was 41 and the duration of the disease between 1 -18 years [the mean was 9 years]. Half of the patients were farmers. The color of the mycetoma grains was black in 12 patients and white to yellow in 4.The right foot was affected by the disease in 14 patients; the left foot and the right knee was involved in each of the remaining 2 cases. The bone was involved in 6 patients, and 6 patients gave a history of trauma or thorn prick. The causative organism was Eumycetoma in 14 cases and Actinomycetoma in two. Eumycetoma patients were treated with Itraconazole and surgery or Ketoconazole and surgery or Itraconazole only or Ketoconazole only The Actinomycetoma cases were treated with Cotrimoxazole with surgery or with Cotrimoxazole only.11 patients were greatly improved with their treatment. Mycetoma is widespread in Yemen. As it is part of the international mycetoma belt, multi-center studies are needed to evaluate the extent of the disease and to find out a standard policy of management and prevention