Abstract
“Madura foot” or pedal mycetoma is a rare destructive infection of the skin and subcutaneous tissues of the foot, progressing to involve muscle and bone. The infection can be caused by both bacteria and fungi. Infection typically follows traumatic implantation of bacteria or fungal spores, which are present in soil or on plant material. Clinically, this entity can be difficult to diagnose and can have an indolent and progressive course. Early diagnosis is important to prevent patient morbidity and mortality. We present two cases of pedal mycetoma, review the literature, review new developments in diagnosis, and discuss magnetic resonance imaging (MRI) features of this unusual entity.
This is a preview of subscription content, log in via an institution to check access.
References
Welsh O. Mycetoma. Semin Dermatol. 1993;12(4):290–5.
Fahal AH, Hassan MA. Mycetoma. Br J Surg. 1992;79(11):1138–41.
Sharif HS, Clark DC, Aabed MY, Aideyan OA, Mattsson TA, Haddad MC, et al. Mycetoma: comparison of MR imaging with CT. Radiology. 1991;178(3):865–70.
Abd El Bagi ME, Sammak BM, Al Shahed MS, Yousef BA, Demuren OA, Al Jared M, et al. Rare bone infections “excluding the spine”. Eur Radiol. 1999;9(6):1078–87.
Cherian RS, Betty M, Manipadam MT, Cherian VM, Poonnoose PM, Oommen AT, et al. The “dot-in-circle” sign—a characteristic MRI finding in mycetoma foot: a report of three cases. Br J Radiol. 2009;82(980):662–5.
Venkatswami S, Sankarasubramanian A, Subramanyam S. The Madura foot: looking deep. Int J Low Extrem Wounds. 2012;11(1):31–42.
El Muttardi N, Kulendren D, Jemec B. Madura foot—mind the soil. J Plast Reconstr Aesthet Surg. 2010;63(7):e576–8.
Sarris I, Berendt AR, Athanasous N, Ostlere SJ, Group Ocs. MRI of mycetoma of the foot: two cases demonstrating the dot-in-circle sign. Skelet Radiol. 2003;32(3):179–83.
Borman AM, Linton CJ, Miles SJ, Johnson EM. Molecular identification of pathogenic fungi. J Antimicrob Chemother. 2008;61 Suppl 1:i7–12.
Sakayama K, Kidani T, Sugawara Y, Fujibuchi T, Miyawaki J, Miyazaki T, et al. Mycetoma of foot: a rare case report and review of the literature. Foot Ankle Int/Am Orthop Foot Ankle Soc/Swiss Foot Ankle Soc. 2004;25(10):763–7.
Cockshott P, Howard M. Clinical radiology in the tropics. New York: Edinburgh; 1979.
Gold RH, Mirra JM. Case report 442. Madura foot (mycetoma pedis). Skelet Radiol. 1987;16(7):577–80.
Foltz KD, Fallat LM. Madura foot: atypical finding and case presentation. J Foot Ankle Surg. 2004;43(5):327–31.
Ameen M, Arenas R. Developments in the management of mycetomas. Clin Exp Dermatol. 2009;34(1):1–7.
Ching BY, Maraczi G, Urbina D. Madura foot. A case presentation. J Am Podiatr Med Assoc. 1991;81(8):443–7.
Fletcher CL, Moore MK, Hay RJ. Eumycetoma due to Madurella mycetomatis acquired in Jamaica. Br J Dermatol. 2001;145(6):1018–21.
Verdolini R, Amerio P, Bugatti L, Manso E, Cataldi I, Brancorsini D, et al. Madura’s foot: report of a case caused by Madurella mycetomatis. Eur J Dermatol. 2000;10(8):627–9.
Kumar J, Kumar A, Sethy P, Gupta S. The dot-in-circle sign of mycetoma on MRI. Diagn Interv Radiol. 2007;13(4):193–5.
Baveja CP, Gumma VN, Jain M, Jha H. Foot ulcer caused by multidrug-resistant Mycobacterium tuberculosis in a diabetic patient. J Med Microbiol. 2010;59(Pt 10):1247–9.
Yera H, Bougnoux ME, Jeanrot C, Baixench MT, De Pinieux G, Dupouy-Camet J. Mycetoma of the foot caused by Fusarium solani: identification of the etiologic agent by DNA sequencing. J Clin Microbiol. 2003;41(4):1805–8.
Lewall DB, Ofole S, Bendl B. Mycetoma. Skelet Radiol. 1985;14(4):257–62.
Reeder MM, Palmer PES. The radiology of tropical diseases with epidemiological, pathological, and clinical correlation. Baltimore: Williams & Wilkins; 1981.
Goldsmith LA, Katz SI, Gilchrest BA, et al. Fitzpatrick’s dermatology in general medicine. 8th ed. New York: McGraw & Hill; 1999.
Czechowski J, Nork M, Haas D, Lestringant G, Ekelund L. MR and other imaging methods in the investigation of mycetomas. Acta Radiol. 2001;42(1):24–6.
McElroy JA, de Almeida Prestes C, Su WP. Mycetoma: infection with tumefaction, draining sinuses, and “grains”. Cutis. 1992;49(2):107–10.
Alam K, Maheshwari V, Bhargava S, Jain A, Fatima U, Haq EU. Histological diagnosis of Madura foot (mycetoma): a must for definitive treatment. J Global Infect Dis. 2009;1(1):64–7.
Ahmadi ME, Morrison WB, Carrino JA, Schweitzer ME, Raikin SM, Ledermann HP. Neuropathic arthropathy of the foot with and without superimposed osteomyelitis: MR imaging characteristics. Radiology. 2006;238(2):622–31.
Hsu CY, Lu HC, Shih TT. Tuberculous infection of the wrist: MRI features. AJR Am J Roentgenol. 2004;183(3):623–8.
Lupi O, Tyring SK, McGinnis MR. Tropical dermatology: fungal tropical diseases. J Am Acad Dermatol. 2005;53(6):931–51. quiz 952–934.
Funding
The authors have no grants or other assistance.
Disclosure
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
White, E.A., Patel, D.B., Forrester, D.M. et al. Madura foot: two case reports, review of the literature, and new developments with clinical correlation. Skeletal Radiol 43, 547–553 (2014). https://doi.org/10.1007/s00256-013-1751-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-013-1751-z