Case Number : Case 51 Posted By: Guest

Phillip McKee - Overseas consultations (USA) Wrote:

The diagnosis is Madurella mycetoma caused by M. mycetomatis. As you rightly say special stains help distinguish actinomycetic from fungal (eumycetic) causes of mycetoma with the latter positive for PAS and sliver stains. Thank you all for your contributions and better luck with the next spot!

Submitted on 19/08/2010 21:00
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Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Thanks a lot professor, thanks a lot to everybody, I am learnning a lot!

Submitted on 19/08/2010 15:34
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

I think the color of grains may point to the organism. Eumycetoma (fungal mycetoma)usually produce brown black grains or pale grains. Actinomycetoma (bacterial mycetoma) produce red or yellow or pale grains. I think I am seeing red grains here. However, the sure method to differentiate is to do special stains, the simplest is Gram stain. Eumycetes are gram negative, while actinomycetes are gram positive.

Submitted on 19/08/2010 14:17
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Phillip McKee - Overseas consultations (USA) Wrote:

Certainly a mycetoma - no brownie points for that - but is it fungal or bacterial ?? How confident are you it is actinomycetoma - I think we need further suggestions!

Submitted on 19/08/2010 13:49
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Lea Singh - USA () Wrote:

Mycetoma - are they not described by the colour of the grains?

Submitted on 19/08/2010 13:44
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Stephen - Appleby (UK) Wrote:

Actinomycetic Mycetoma

Submitted on 19/08/2010 13:43
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Rodrigo Restrepo - UPB (Colombia) Wrote:

Actinomycetic Mycetoma

Submitted on 19/08/2010 12:19
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Gonzalo De Toro - Universidad Austral (Puerto Montt, Chile) Wrote:

I agree with Actinomycetic Mycetoma with Splendore Hoeppli phenomenon. Nice picture.

Submitted on 19/08/2010 05:42
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Marcela Saeb Lima - MSLDermatopato (Mexico, City) Wrote:

Mycetoma, it looks like Nocardia with that kidney shape and the Splenodre Hoeppli

Submitted on 19/08/2010 04:40
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Marwa Fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Actinomycetoma caused by Actinomadura pelletieri (red grains ).

Submitted on 19/08/2010 00:50
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Mycetoma.

Submitted on 19/08/2010 00:48
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Actinomycetic Mycetoma. Red grains of Actinomadura pelletieri surrounded with Splendore Hoeppli phenomenon and suppurative granuloma.

Submitted on 18/08/2010 22:29
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