Mycetomic osteitis and bone mycetoma

Seance of wednesday 26 february 2003 (SEANCE A DAKAR (SENEGAL))

Abstract

Mycetoma is a bacteriological or fungal infectious disease affectingthe skin and/or soft tissues. Bone and/or joints lesions represent aserious complication that worsens the functional and aesthetic prognosis.The aim of this study was to classify and evaluate the frequencyof different bone and joint lesions in mycetoma.This review of 195 patients treated in the UTH in Dakar betweenJuly 1988 and November 2001 revealed 99 osteitis and/or osteoarthritisin 66 males and 33 females with an average age of 35 years(8-88 years). Sixty nine (69) X-rays and 13 CT -scan were retrievedand studied by a team composed of 3 orthopedic surgeons and 2radiologists. The causal agent and clinical manifestations, the natureand localization of the lesions, and the type of treatment, surgical(n=45) versus medical (n=15), were recorded.The frequency of bone and joint lesions was 50.7%. 56.5% of thelesions affected the foot. The metatarsal was the most affected anatomicalregion (42.5%), the first metatarsian the most affected bone(9.63%), and the tarso-metatarsian the most destroyed joint (n=19,51.3%). The etiology was predominantly fungal (75.3%), with lesionscharacterized by bone lysis and articular dislocation. Treat -ment consisted mainly in amputation or disarticulation (50.7%).In the Senegalese endemic zone, the authors differentiate secondarylesions (94.5%) or mycetomic osteitis from primitive bone mycetoma(5.1%)