Mycetoma: epidemiology, treatment challenges, and progress

Mycetoma is a chronic infectious disease of the subcutaneous tissue with a high morbidity. This disease is most commonly seen in countries between 30°N and 15°S of the equa- tor, but cases have also been seen in Europe and the USA. Due to the lack of proper prevalence data, currently the true burden of this disease is not known. Mycetoma can be caused by a large variety of microorganisms, both bacteria and fungi. Treatment of the disease depends on the etiology of the causative agent. Actinomycetoma is usually treated with antibiotics only and has a decent cure rate; eumycetoma is treated with a combination of antibiotics and surgery. Unfortunately, for eumycetoma, recurrent infections are common and amputations are still needed in a large proportion of the patients.