Mycetoma management and clinical outcomes: the Mycetoma Research Center experience.

Autor:	Musa EA; Clinical Pharmacy Program, Faculty of Pharmacy, University of Khartoum, Khartoum 11115, Sudan., Abdoon IH; Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum 11115, Sudan., Bakhiet SM; Mycetoma Research Center, University of Khartoum, Khartoum 11115, Sudan., Osman B; Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum 11115, Sudan., Abdalla SA; Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum 11115, Sudan., Fahal AH; Mycetoma Research Center, University of Khartoum, Khartoum 11115, Sudan.
Jazyk:	angličtina
Zdroj:	Transactions of the Royal Society of Tropical Medicine and Hygiene [Trans R Soc Trop Med Hyg] 2023 Jan 03; Vol. 117 (1), pp. 12-21.
DOI:	10.1093/trstmh/trac069
Abstrakt:	Background: Mycetoma is a chronic granulomatous inflammatory disease that affects the cutaneous and subcutaneous tissues, leading to gruesome complications if not treated early. As a neglected disease, it has received scant attention in developing curable drugs. Mycetoma treatment is still based on expert opinions in the absence of guidelines. Methods: This descriptive, cross-sectional, hospital-based study aimed to determine and assess the disease treatment outcomes observed at Mycetoma Research Center, Sudan. Results: In this study, 75% of patients had eumycetoma, all of whom were treated with itraconazole and 37.4% underwent surgical excision, while 25% of the patients had actinomycetoma, 99.2% of whom were treated with a combination of cotrimoxazole and amoxicillin-clavulanate. The cure rate was 12.7% and 14.3% for patients with eumycetoma and actinomycetoma, respectively. Only 6.1% of eumycetoma patients underwent amputation. Remarkably, no patient with actinomycetoma underwent an amputation. Small lesions (OR=10.09, p<0.001) and good follow-up (OR=6.81, p=0.002) were positive predictors of complete cure. In terms of amputation, history of surgical recurrence at presentation (OR=3.67, p=0.020) and presence of grains (OR=7.13, p=0.012) were positive predictors, whereas small lesions were negative predictors (OR=0.06, p=0.009). Conclusions: Treatment of mycetoma was suboptimal, with a low cure rate despite a long treatment duration. Complete cure has a significant association with small lesions and good follow-up. (© The Author(s) 2022. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu