Mycetoma at a tertiary care hospital in Saudi Arabia: Correlation of histopathological and clinical findings

ABSTRACT

Objective: To present the histopathological and clinical correlation of mycetoma among patients attending King Abdulaziz University Hospital between 1998-2013. Methods: The data of all histopathologically diagnosed mycetomas in the period between January 1998 and January 2013 were collected through a computerized database search of the anatomic pathology archives at King Abdulaziz University Hospital. The collected data were analysed. Identification of species were performed for five patients using 16S ribosomal DNA and internal transcribed spacer 2. Results: There were 19 patients with mycetoma with an average age of 44.26 years and male: female ratio of 4:1. Actinomycetoma were 63.15% and eumycetoma were 36.84%. All patients presented with the classic lesions; presenting as painless subcutaneous mass, sinuses and discharge containing grains. The swellings were of slow evolution, with preferential foot localization. Species specification performed for samples from five patients with active lesions revealed species of Actinomyces israelii and Madurella mycetomatis in respective cases. Conclusions: Actinomycetoma is more common than eumycetoma in this region. The fact that one of the patients with eumycetoma was a Saudi national raises the possibility of an indigenous species similar to Maduraella mycetomatis to be further explored for characteristics and pathogenesis. The disease has to be prioritized again and more robust and quick molecular diagnostic tools should be made available in order to save patients form disfiguring amputations.