Table 2.
Complications and sequalae related to eumycetoma.
| Author | Year | Study design | Study period | Country | Level of care | Population description | Number of patients N (%) | Disability N (%) |
|---|---|---|---|---|---|---|---|---|
| Abbas et al.32 | 2018 | Qualitative research Single-centre |
May 2016–January 2017 | Sudan | Tertiary | Patients with confirmed mycetoma | 300 228 (76%) were male |
181 (60.3%) had moderate impairment or difficulty in at least one of the eight life domains. 119 (39.7%) had a mobility impairment or difficulty walking. 103 (34.3%) had significant pain. 126 (46.7%) reported difficulty in their ability to economically sustain themselves. |
| Abdelrahman et al.7 | 2019 | Case series Multi-centre |
2013–2016 | Sudan | Tertiary | Patients with eumycetoma suitable for reconstruction post-excision | 26 | 9/26 (34.6%) operations were for recurrent eumycetoma. Post-operative interviews: Adequate satisfaction with the cosmetic result. Mobility in all patients (100%) returned to pre-morbid state. |
| Fahal et al.10 | 2015 | Retrospective cohort study Single-centre |
January 1991–July 2014 | Sudan | Tertiary | Patients with confirmed mycetoma | 6792 |
Median duration of disease was 3 years (mean 6 ± 0.1 SE). Localized pain was reported in 1834 (27%). 3847 (57%) had previous surgical excisions and recurrence. 807 (11.8%) had an amputation. Due to the prolonged illness and disability, 628 (9%) patients were unemployed. |
| Fahal et al.29 | 2015 | Case series Single-centre |
January 1991–October 2014 | Sudan | Tertiary | Patients with confirmed head and neck mycetoma | 49 16 (32.7%) had eumycetoma |
Median duration of disease was 11.23 ± 19.7 years. 11 (22.4%) have pain at the site of disease. 36 (73.5%) had a prior history of recurrent disease and surgical excisions. Due to the prolonged illness and disability, 7 (14.3%) patients were unemployed. Antifungal therapy with various surgical excisions was used as a treatment. 14 (28.5%) were lost to follow up. |
| Mhmoud et al.26 | 2014 | Prospective cohort study Single-centre |
January 2011–June 2013 | Sudan | Tertiary | Patients with confirmed Madurella mycetomatis eumycetoma and Staphylococcus aureus co-infection | 337 |
Complete or partial response
86/142 (60.6%) of those who received amoxicillin–clavulanic acid and ketoconazole vs. 28/93 (30.1%) of those who received ciprofloxacin and ketoconazole vs. 37/102 (36.3%) of those who received ketoconazole alone. Mobility 123/139 (88.5%) of the amoxicillin–clavulanic acid and ketoconazole treated group had no mobility issues vs. 2/93 (2.2%) of the ciprofloxacin and ketoconazole-treated group. (P < .001) Amputation 4/142 (2.8%) of the amoxicillin–clavulanic acid and ketoconazole-treated group vs. 11/93 (12%) of the ciprofloxacin and ketoconazole-treated group. |
| Sow et al.11 | 2020 | Retrospective cohort study Multi-centre |
January 2008–December 2018 | Senegal | Tertiary | Patients diagnosed with mycetoma | 193 91 (47.2%) had eumycetoma |
90 (46.6%) had a mycetoma for 1–5 years. 29 (31.8%) had eumycetoma for 5–10 years. 102 (52.8%) had pain at the site. 76/91 (83.5%) of those with a eumycetoma had prior traditional phytotherapy. 68 (74.7%) of those with a eumycetoma were treated with terbinafine. 35/91 (38.5%) of those with a eumycetoma had an amputation. 43 (47.3%) of those with a eumycetoma made a full recovery following treatment. |
| Zein et al.27 | 2012 | Prospective cohort study Single-centre |
January 2004–January 2009 Follow up until May 2011 |
Sudan | Tertiary | Patients with mycetoma | 1544 1242 (80.4%) had a eumycetoma. Of those with a eumycetoma, 971 (78.2%) were male, and the median age was 25 (range 4–80) years of age |
35/1242 (2.8%) of those with a eumycetoma had an amputation. 671 (54%) of those with a eumycetoma dropped out of out-patient clinical reviews. Predictors of amputation: Larger lesions 5–10 cm c/w <5 cm in size OR 1.7: 95% CI 0.3–10.2, >10 cm c/w <5 cm in size OR 20.9: 95% CI 6.2–70.5 Longer duration of disease OR 1.1: 95% CI 1.0–1.1 |
N, number; SE, standard error; C/w, compared with; OR, odds ratio; CI, confidence interval.