Madurella mycetomatis infection of the buttock in an Eritrean refugee in Switzerland: a case report.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_38206B704A7C
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Madurella mycetomatis infection of the buttock in an Eritrean refugee in Switzerland: a case report.
Journal
Journal of medical case reports
Author(s)
Mekoguem C., Triboulet C., Gouveia A.
ISSN
1752-1947 (Electronic)
ISSN-L
1752-1947
Publication state
Published
Issued date
12/02/2019
Peer-reviewed
Oui
Volume
13
Number
1
Pages
32
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: epublish
Abstract
Mycetoma is a neglected infectious disease caused by a fungus (eumycetoma) or bacteria (actinomycetoma); it is characterized by chronic local inflammation with sinus formation and purulent discharge. Its course can be quite devastating because of the difficulty in diagnosing the infection and in eliminating the causative agent. Although endemic in many countries in the tropics and subtropics, the migration of Africans to Europe may increase the presence of this neglected disease in European countries. We present a case of an Eritrean patient living in a non-endemic country who was diagnosed as having an infection of Madurella mycetomatis in an atypical location in his body.
We report the case of a 35-year-old African male refugee from Eritrea, living in Switzerland since 2015, who presented with a 1-year history of a painful soft tissue swelling associated with dark nodules in his right buttock. He mentioned having several previous surgeries after 2001 while he was in Eritrea due to recurrent abscess formation on this body area. In the previous months, the swelling had become more significant and nodules started draining a purulent fluid. An initial diagnostic hypothesis of buttock abscess was made and he was referred to a dermatologist for diagnostic confirmation and further specialist care due to the size and atypical presentation. After a punch biopsy, the diagnosis of eumycetoma was confirmed and cultures developed Madurella mycetomatis. The initial treatment approach consisted of oral treatment by itraconazole; however, a surgical resection of the lesions was finally needed.
Although rare, mycetoma should be diagnosed as early as possible to avoid long-lasting complications. Primary care physicians in European countries are frequently in the first line of care of migrant patients and therefore should be aware of the common and uncommon clinical presentations of mycetoma.
Keywords
Adult, Antifungal Agents/therapeutic use, Biopsy, Buttocks/microbiology, Buttocks/surgery, Eritrea/ethnology, Humans, Itraconazole/therapeutic use, Madurella/isolation & purification, Male, Mycetoma/diagnosis, Mycetoma/drug therapy, Mycetoma/surgery, Refugees, Switzerland, Actinomycetoma, Eumycetoma, Madurella mycetomatis, Migrant health, Mycetoma, Primary care
Pubmed
Open Access
Yes
Create date
25/03/2019 9:44
Last modification date
20/08/2019 13:26
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