Actinomycetomas in Senegal: study of 90 cases

Mycetoma is a pathological process during which eumycetomic (fungal) or actinomycotic causative agents from exogenous source produce grains. Medical treatment is available for actinomycetomas and surgery is still the main treatment for eumycetoma. We report 90 cases of actinomycetoma occuring in male adult patients coming mainly from central Senegal. Patients living far from health structures consult after a long evolution period for tumors and pains which prevent them from carrying out their activities. The three etiological agents in our patients were Actinomadura pelletieri (60 cases), Actinomadura madurae (25 cases) and Streptomyces somaliensis (5 cases). The three clinical features are inflammatory forms (75 cases) mainly due to Actinomadura pelletieri, tumoral forms (13 cases) and cystic forms (2 cases). Lesions are localized on the foot in 50% of cases and in other part of the body for the other half. Bone damage was observed in 55% of cases. 83% of the patients were cured after a one-year treatment of sulfametoxazole adminstered orally. Two patients died of visceral involvement.