Project description:Mycetoma is a neglected chronic and granulomatous infection primarily associated with the fungal pathogen Madurella mycetomatis. Infection is characterised by the formation of fungal grains inside the infected tissue which commonly result in severe deformity and disability. Currently the biochemical processes and interactions between host and pathogen which result in grain formation are unknown. Furthermore, the infection process in mammals takes months to fully develop. In order to unravel these processes Galleria mellonella larvae were infected with M. mycetomatis and hyphae and grain formation, survival, fungal burden and proteomic responses of larvae were monitored for 10 days. At 24 h post infection proteins indicative of muscle invasion and humoral immune response activation were enriched in infected larval hemolymph. By 72 h immune related hdd11 was increased 337 fold, heat shock proteins 90 was increased 40 fold and glutathione-S-transferase was increased 25 fold. By 7 days post infection proteins which were associated with grain formation (hdd11 [533 fold], hemocentin [54 fold]) and a range of antimicrobial peptides were enriched. During the 7 day period a variety of proteins were decreased in infected hemolymph (e.g. hexamerin, apolipophorin and cationic peptide CP8). This data also identified 75 M. mycetomatis proteins released into hemolymph during infection. Proteins were also extracted from M. mycetomatis grains taken from larvae infected for 24, 72 and 7 days. These proteins give an insight into the interactions between the larval immune response and M. mycetomatis at the cellular levels during infection. These results identify similarities between the infection processes of M. mycetomatis in G. mellonella larvae and in humans and identify novel proteins from M. mycetomatis which may play a crucial role in grain development.
Project description:Mycetoma is a progressive destructive disease causing severe disability, if untreated, in otherwise healthy people. Susceptible populations are usually adult males and disease is characterized by the triad of tumor formation, presence of grains and draining sinuses. Here, we report a case of mycetoma of a young female, manifested only as a painful swelling over left ankle which was initially suspected as a malignancy. The preliminary diagnosis of mycetoma came with the presence of characteristic "dot in circle" sign in radiological evaluation which was confirmed by the positive fungal culture of 2nd biopsy for M. mycetomatis.
Project description:Currently, therapy of black-grain mycetoma caused by Madurella mycetomatis consists of extensive debridement of the infected tissue combined with prolonged antifungal therapy with ketoconazole or itraconazole. In the present study, the in vitro activity of the new triazole isavuconazole toward M. mycetomatis was evaluated. Isavuconazole appeared to have high activity against M. mycetomatis, with MICs ranging from ?0.016 to 0.125 ?g/ml. Due to its favorable pharmacokinetics, isavuconazole could be a promising antifungal agent in the treatment of mycetoma.
Project description:Mycetoma is a neglected tropical disease which is endemic in Senegal. Although this subcutaneous mycosis is most commonly found on the foot, extrapodal localisations have also been found, including on the leg, knee, thigh, hand, and arm. To our knowledge, no case of blood-spread eumycetoma has been reported in Senegal. Here, we report a case of pulmonary mycetoma secondary to a Madurella mycetomatis knee eumycetoma. The patient was a 41-year-old farmer living in Louga, Senegal, where the Sudano-Sahelian climate is characterised by a short and unstable rainy season and a steppe vegetation. He suffered a trauma to the right more than 20 years previously and had received treatment for more than 10 years with traditional medicine. He consulted at Le Dantec University Hospital in Dakar for treatment of a right knee mycetoma which had been diagnosed more than 10 years ago. He had experienced a chronic cough for more than a year; tuberculosis documentation was negative. Grains collected from the knee and the sputum isolated M. mycetomatis, confirmed by the rRNA gene ITS regions nucleotide sequence analysis. An amputation above the knee was performed, and antibacterial and antifungal therapy was started with amoxicillin-clavulanic acid and terbinafine. The patient died within a month of his discharge from hospital.