(Figure 4A & B) Gram staining was performed to distinguish between actinomycetoma and eumycetoma
which showed gram negative septate hyphae.
The skin lesion typically presents with multiple purulent discharging sinuses, which are often confused with the eumycetoma
They are pigmented moulds found in soil and in plants and can give rise to three clinical entities such as eumycetoma
, chromoblastomycosis, and phaeohyphomycosis.
Most probably transmitted through pricks to the skin by walking barefoot, eumycetoma
is a chronic condition that affects people in tropical and subtropical regions, in particular across Africa, with the highest burden found in Sudan.
venezuelense 28/M  Number Underlying Clinical disease condition 1 None Subcutaneous infection of the foot 2 Rheumatoid arthritis Subcutaneous mass of the foot 3 None Subcutaneous nodule below the knee 4 None Fistulized nodule on the ankle 5 Renal transplant Multiple nodules of ankle and foot 6 Myelodysplastic Olecranon bursitis syndrome, IgA deficiency 7 Cardiac transplant Multiple skin lesions 8 None Mycetoma 9 Renal transplant Draining cystic tumors on the foot 10 Penetrating Endophthalmitis globe injury 11 Kidney transplant Subcutaneous nodule on the forefinger 12 None Subcutaneous abscess on the forearm 13 None Onychomycosis 14 Type 2 diabetes Eumycetoma
is more common in areas where the average rainfall is scarce, while actinomycetoma tends to appear in areas with abundant rainfall.
Actinomycetoma is caused by actinomycetes, whereas eumycetoma
is caused by fungi.
One case of mycetoma showed thick hyphae of eumycetoma
, while neither yeast like cells or asteroid bodies were seen in sporotrichosis which is similar to other studies, possibly due to the paucity of yeasts in tissues.
Actinomycetoma is amenable to medical treatment by antibiotics and antimicrobial agent combinations, while combined medical and surgical treatment is the gold standard in eumycetoma
. In general, the current treatment for mycetoma is unsatisfactory--it needs to be of long duration to achieve cure, has many side-effects, has a high relapse rate, and is expensive for patients and health authorities.
It is the most common cause of eumycetoma
in the United States.
When the causative agent for Mycetoma is a fungus, it is termed as Eumycetoma
and when it is caused by filamentous bacteria, it is termed as Actinomycetoma.
 Pinoy, in 1913, subdivided the mycetomas into two groups: one caused by Eumycetes or "true fungi", Eumycetoma
and other by aerobic filamentous bacteria belonging to class "Actinomycetes" named Actinomycetoma.