Official reprint from UpToDate®
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Beatriz Bustamante, MD
Pablo E Campos, MD, MPH
Section Editor
Carol A Kauffman, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Eumycetoma ("mycotic mycetoma") is a chronic subcutaneous fungal infection of the skin and soft tissue, most often affecting the lower extremity (typically a single foot) [1]. It is caused by more than 30 hyaline and pigmented species of molds. Filamentous higher bacteria can cause similar clinical manifestations (actinomycotic mycetoma or actinomycetoma); these organisms are discussed separately [2]. (See "Clinical manifestations and diagnosis of nocardiosis", section on 'Mycetoma'.)

Infection typically occurs following skin or subcutaneous tissue inoculation of conidia via a contaminated thorn or splinter. Eumycetomas are usually confined to subcutaneous tissues but can involve fascia, bone, and regional lymph nodes via contiguous dissemination [3].

Issues related to epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention of eumycetoma will be reviewed here. Issues related to actinomycotic mycetoma caused by filamentous higher bacteria are discussed separately. (See "Treatment of nocardiosis".)


Most cases of eumycetoma occur among individuals living in developing countries in tropical and subtropical regions, although cases have been reported worldwide (including in countries in temperate regions). Eumycetoma typically affects healthy adult men such as field laborers or farmers who work in rural areas and have frequent exposure to soil. The mean age is 33 but ranges from 8 to 68 years; pediatric cases are rare. The male to female ratio is about 3:1 to 5:1.

Eumycetoma among animals is rare but has been reported in horses, water buffalo, and dogs. There are no known cases of zoonotic or laboratory acquisition of eumycetomas, nor has person-to-person transmission been described.


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Literature review current through: Sep 2016. | This topic last updated: Jan 21, 2016.
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