Chest X-ray showing multiple bilateral lungs patches with the differential diagnosis of secondaries, miliary tuberculosis, or mycetoma infiltrations.

<p>Chest X-ray showing multiple bilateral lungs patches with the differential diagnosis of secondaries, miliary tuberculosis, or mycetoma infiltrations.</p

Chest CT scan showing numerous multiple lung nodules with multiple dot-in sign characteristic for mycetoma.

<p>Chest CT scan showing numerous multiple lung nodules with multiple dot-in sign characteristic for mycetoma.</p

X-ray of the patient’s right knee joint region showing massive soft tissue mass and condylar notch widening with massive effusion.

<p>X-ray of the patient’s right knee joint region showing massive soft tissue mass and condylar notch widening with massive effusion.</p

The thigh mass ultrasound examination showing multiple massive cystic masses with hyper-reflective echoes in line with eumycetoma.

<p>The thigh mass ultrasound examination showing multiple massive cystic masses with hyper-reflective echoes in line with eumycetoma.</p

Showing massive knee eumycetoma with multiple active sinuses, discharge, and black grains.

<p>Showing massive knee eumycetoma with multiple active sinuses, discharge, and black grains.</p

The knee region MRI showing extensive enhancing solid mass with nodule components, infiltrating the muscular components of anterior and posterior lower thigh with intra-articular extension and bony cortical defect at lateral femoral condyle.

<p>The knee region MRI showing extensive enhancing solid mass with nodule components, infiltrating the muscular components of anterior and posterior lower thigh with intra-articular extension and bony cortical defect at lateral femoral condyle.</p

Hand Mycetoma: The Mycetoma Research Centre Experience and Literature Review.

Mycetoma is a devastating, neglected tropical disease characterised by extensive tissue involvement resulting in destruction, deformities and disabilities in the affected patients. The hand is commonly affected by mycetoma thus compromises its functionality and hinder the patient's daily activities of living. In this communication, we report on 533 patients with hand mycetoma managed over a period of 24 years at the Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan. Eumycetoma was the commonest type of mycetoma (83.3%) encountered. Males were predominately affected (69.2%) with a sex ratio of 2.2:1. The majority of the patients (84%) were young adult below the age of 40 years old at presentation. The generality of patients (86.4%) were from the Sudan mycetoma belt. Children and adolescents (28.1%), farmers (18.2%) and workers (17.4%) were more frequently affected. The majority of patients (67.4%) had disease duration of less than 5 years at presentation. The study, did not document significant history of local trauma, familial tendency, concomitant medical diseases or other predisposing cause for mycetoma in this population. Pain (23.1%) was not a disease feature in this series and 52% of patients had past surgery for mycetoma and recurrence. The right hand was affected most (60.4%), and 64% of them had small lesion at presentation. Conventional x-ray was only helpful in patients with advanced disease and the MRI accurately determined the disease extension. Cytological smears, surgical biopsies histopathological examination and grains culture were the principal diagnostic tools for causative organisms' identification. In the present series it was difficult to determine the treatment outcome due to high patients follow up dropout

Showing massive hand actinomycetoma.

<p>Showing massive hand actinomycetoma.</p

The demographic characteristics of the studied population.

<p>The demographic characteristics of the studied population.</p