Table 3.
Demographics, clinical characteristics, and outcome in patients with phaeohyphomycosis and eumycetoma caused by M. romeroi.
| Demographics | All Cases (n = 52) |
Eumycetoma (n = 14) |
Phaeohyphomycosis (n = 38) |
|---|---|---|---|
| Male gender, n (%) * | 34 (66%) | 11 (85%) | 23 (60%) |
| Age at diagnosis (yr), mean, (range) | 52 (18–88) | 42 (24–63) | 54 (18–88) |
| Geographical region of origin, n (%) ** | |||
| Indian subcontinent, n (%) | 24 (51%) | 5 (42%) | 19 (54%) |
| Africa, n (%) | 13 (27%) | 4 (33%) | 9 (26%) |
| Southeast Asia, n (%) | 7 (15%) | 1 (8%) | 6 (17%) |
| Europe, n (%) | 2 (4%) | 1 (8%) | 1 (3%) |
| South America n (%) | 1 (2%) | 1 (8%) | 0 |
| Patients resident in Europe or USA, n (%) * | 25 (49%) | 2 (15%) | 23 (60%) |
| Tropical/subtropical origin in Europe/USA cases n (%) ‡ | 19 (90%) | 1 (50%) | 18 (95%) |
| Time delay between last travel and onset of disease (yr), mean | 6 | 11 | 5 |
| Agricultural work, n (%) | 12 (23%) | 5 (36%) | 7 (18%) |
| Clinical characteristics | |||
| Single lesion, n (%) ⁋ | 40 (82%) | 11 (100%) | 29 (76%) |
| Multiple lesions, n (%) | 9 (18%) | 0 | 9 (24%) |
| Painful lesion (%) ¥ | 16 (53%) | 3 (60%) | 13 (52%) |
| Growth speed § | |||
| Slow (%) | 10 (77%) | NA | 10 (77%) |
| Fast (%) | 3 (23%) | NA | 3 (23%) |
| Presentation | |||
| Nodules (%) | 33 (63%) | NA | 33 (87%) |
| Verrucous lesions (%) | 2 (4%) | NA | 2 (5%) |
| Draining sinus (%) | - | - | 5 (13%) |
| Body area involved Þ | |||
| Lower limb, n (%) | 37 (75%) | 10 (91%) | 27 (71%) |
| Upper limb, n (%) | 10 (20%) | 1 (9%) | 9 (24%) |
| Underlying disease, n (%) | 32 (61%) | 0 | 32 (84%) |
| Solid-organ transplantation | 15 (29%) | 0 | 15 (39%) |
| Systemic steroids for inflammatory diseases | 9 (17%) | 0 | 9 (24%) |
| Diabetes | 13 (25%) | 0 | 13 (34%) |
| None Disease mean duration before treatment (mth), (range) |
19 (36%) 34 (1–204) |
14 (100%) 94 (18–204) |
5 (13%) 12 (1–48) |
| Outcome after treatment | |||
| First-line treatment outcome, n of cases | 44 | 7 | 37 |
| Surgery alone | 14 | 3 | 11 |
| Complete remission n (%) | 7 (50%) | 0 (0%) | 7 (63%) |
| Antifungal treatment alone | 14 | 3 | 11 |
| Complete remission n (%) Stability/partial improvement |
1 (7%) 2 (14%) |
0 (0%) 1 (33%) |
1 (9%) 1 (9%) |
| Surgery and antifungal treatment | 16 | 1 | 15 |
| Complete remission n (%) | 11 (68%) | 0 (0%) | 11 (73%) |
|
n of treatment events considering all lines received as independent events |
61 | 10 | 51 |
| Surgery alone ŧ | 15 | 3 | 12 |
| Complete remission n (%) | 7 (58%) | 0 (0%) | 7 (78%) |
| Antifungal treatment alone £ | 24 | 6 | 18 |
| Complete remission n (%) | 2 (9%) | 0 (0%) | 2 (12%) |
| Stability/partial improvement | 6 (27%) | 2 (33%) | 4 (25%) |
| Surgery and antifungal treatment © | 22 | 1 | 21 |
| Complete remission n (%) | 16 (80%) | 0 (0%) | 16 (84%) |
Abbreviations: mth: month, NA: not available. * Based on 51 cases (sex and country of residency not available in one mycetoma case), ** based on 50 cases (origin not available in three and two cases of PHM and mycetoma, respectively), ‡ based on 21 cases (origin was not defined in four cases reported from Europe and USA), ⁋ based on 49 cases (clinical information not available in three mycetoma cases), ¥ based on 30 cases (information about pain was available in 5 and 25 cases of mycetoma and PHM respectively, § based on 13 cases (information about growth speed was only available in 13 cases), Þ based on 49 cases (information about the site was not available in three mycetoma cases). ŧ based on 12 events (information about surgery alone outcome was not available in three mycetoma cases), £ based on 22 events (information about the outcome was not available in two PHM cases, © based on 20 events (information about the outcome was not available in two PHM cases.