The importance of diagnostic imaging of mycetoma in the foot.

Autor: Guerra-Leal JD; Department of Radiology and Imaging, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. Jose E. Gonzalez', Monterrey, Mexico., Medrano-Danés LA; Department of Radiology and Imaging, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. Jose E. Gonzalez', Monterrey, Mexico., Montemayor-Martinez A; Department of Radiology and Imaging, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. Jose E. Gonzalez', Monterrey, Mexico., Pérez-Rodríguez E; Department of Surgery, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. Jose E. Gonzalez', Monterrey, Mexico., Luna-Gurrola CE; Department of Microbiology, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario 'Dr. Jose E. Gonzalez', Monterrey, Mexico., Arenas-Guzman R; Department of Dermatology, Mycology Section, Hospital General Dr. Manuel Gea Gonzalez, Mexico City, Mexico., Salas-Alanís JC; Department of Research in Dermatology, Hospital ISSSTE Lic. Adolfo Lopez Mateos, Mexico City, Mexico.
Jazyk: angličtina
Zdroj: International journal of dermatology [Int J Dermatol] 2019 May; Vol. 58 (5), pp. 600-604. Date of Electronic Publication: 2018 Dec 18.
DOI: 10.1111/ijd.14351
Abstrakt: Background: Mycetoma is a chronic, localized infection caused by fungi and bacteria. It usually affects the skin, subcutaneous tissue, and bone of exposed areas with deformity of the affected limb, ulcers, and fistula; however, pain is not severe, therefore the patient comes late to hospital for care.
Objective: To establish the diagnosis of mycetoma in the foot by imaging and identify the principal radiological signs.
Materials and Methods: Six patients with foot mycetoma were evaluated with plain x-ray, ultrasound, and magnetic resonance (MR) after confirming the diagnosis by histopathology and culture.
Results: All patients presented the MR "dot-in-circle" sign; four presented "punched out" bone lesions on plain x-ray. The six patients had fistulas, ulceration, a seropurulent exudate, edema, and a foot deformity. Four patients had N. brasiliensis infection with positive anti-Nocardia IgG antibodies, and only half presented bone lesions.
Conclusion: Characteristic findings were foot deformity, edema, bone lesions, ulcers, fistulas and the presence of the "dot-in-circle" sign. We recommend a comprehensive study of patients with plain x-ray and MR.
(© 2018 The International Society of Dermatology.)
Databáze: MEDLINE
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