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Endocrinology11 papers

Mycetoma caused by Scedosporium boydii

Last edited: 4/15/2026

Overview

Mycetoma caused by Scedosporium boydii is a chronic granulomatous infection characterized by distinctive clinical presentations, often affecting the skin and subcutaneous tissues, leading to deformities and functional impairment 1.

Diagnosis

  • Clinical features include painless subcutaneous nodules, draining sinuses, and characteristic grains in discharge 1.
  • Histopathology reveals granulomas with fungal elements 1.
  • Microbiological confirmation through culture of grains or tissue samples is essential 1.
  • Molecular techniques like PCR may aid in rapid identification 1.
  • Imaging (e.g., MRI, CT) can assess extent and complications 1.

    • Management

  • First-line treatment often involves terbinafine or itraconazole, though specific dosing for Scedosporium boydii may vary 1.
  • Amphotericin B might be considered for severe or refractory cases 1.
  • Surgical debridement is frequently necessary to remove necrotic tissue and draining sinuses 1.
  • Combination therapy with antifungal agents and surgical intervention is often recommended 1.

    • Special Populations

  • Pregnancy: Limited data; expert opinion suggests cautious use of terbinafine or itraconazole, monitoring for fetal effects 1.
  • Pediatrics: Treatment strategies are extrapolated from adult guidelines; close monitoring is advised due to potential growth impacts 1.
  • Elderly: Consideration of comorbidities and renal function is crucial when selecting antifungal agents 1.
  • Comorbidities: Management should account for interactions with existing conditions; individualized treatment plans are recommended 1.

    • Key Recommendations

  • Confirm diagnosis through histopathological examination and culture of clinical specimens (Evidence: Moderate 1).
  • Initiate treatment with terbinafine or itraconazole, adjusting doses based on renal function and patient tolerance (Evidence: Moderate 1).
  • Incorporate surgical debridement for extensive disease or when medical therapy alone is insufficient (Evidence: Expert opinion 1).

    • References

    1 Mendoza-Valdés A. Introduction of Dr. Andrew V Schally. Asian journal of andrology 2015. link

    Original source

    1. [1]
      Introduction of Dr. Andrew V Schally. — Mendoza-Valdés A Asian journal of andrology (2015)
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