Mycetoma
Symptoms, transmission, and current treatments for mycetoma
Mycetoma
Symptoms, transmission, and current treatments for mycetoma
What is mycetoma?
Mycetoma is a chronic slow-growing infection that is either bacterial (actinomycetoma) or fungal (eumycetoma) The fungal form of mycetoma is a highly neglected disease that is not well understood or widely studied. Infection begins most often in the foot, probably after a cut or thorn prick allows bacteria or fungi to enter the body. It can spread to other parts of the body. It is initially painless, but slowly and progressively destroys body tissue beneath the skin. Mycetoma affects skin, muscle, and bone, causing severe disability.
Current treatments for fungal mycetoma are difficult to administer, often unaffordable, and difficult to access. Treatment takes many months and is not always effective. Often, amputation is the only option to stop progression of the disease. Even after amputation, there is a high chance of recurrence. The disfigurement and disability caused by mycetoma can lead to social stigma, discrimination, and mental health challenges. The disease places a heavy burden on communities and health services in affected areas. Children and young adults are most at risk.
What is the impact of mycetoma?
- basic epidemiological information is lacking and the overall global burden is unknown
- occurs most often in the so-called ‘mycetoma belt’ between latitudes 15° S and 30° N
- the ‘mycetoma belt’ is characterized by a hot, dry climate with a short, heavy rainy season
- approximately 40% of mycetoma cases worldwide are fungal
- fungal mycetoma has a cure rate of only 80% with current treatments if patients take the full course of treatment but can be as low as 35% due to difficulty in treatment.
What are current treatments for mycetoma?
Fungal mycetoma is usually treated with antifungal drugs followed by removal of the remaining infected area. Amputation is common.
Antifungal drugs used to treat mycetoma are:
- only 25-35% effective in the field and 80% effective if patients take the full course of treatment
- administered for 12 months
- unsafe with many side effects
- too expensive for people with the disease
- frequently unavailable in areas where the disease is found
There is a >90% cure rate for bacterial mycetoma using a combination of antibiotics.
What new treatments for mycetoma are needed?
There is an urgent need for effective, safe, affordable, and shorter treatments for fungal mycetoma that can be used in remote, rural, or resource-constrained settings.
What mycetoma treatments are we working on?
We aim to develop an effective, safe, affordable, and simpler treatment.
Find out about our work developing treatments for mycetoma
How do you get mycetoma?
- Bacteria or fungi enter the body through a cut or penetrating injury, such as a thorn prick.
- People who work in rural settings doing manual labour and people who walk barefoot are most at risk.
- Mycetoma cannot be transmitted from person to person.
What are the symptoms of mycetoma?
Mycetoma usually progresses slowly:
- starts with a painless lump under the skin
- progresses to open infection, discharging small ‘grains’ containing fungal spores
- causes swollen, disfigured body parts – most commonly the hands and feet, back, and buttocks
- deteriorates into a chronic condition as mycetoma spreads to the skin, deep tissue, and bone, resulting in destruction, deformity, and loss of function.
Secondary bacterial infection is also common, which may cause increased pain, disability, sepsis, and even death if untreated.
Many people with mycetoma experience mental health challenges due to the devastating impact of the disease.
How is mycetoma diagnosed?
Mycetoma can be identified by directly examining discharged ‘grains’ of fungal spores under a microscope, but further tests are needed to confirm the diagnosis. There are no simple diagnostic tests to use in remote or rural areas, requiring patients to travel to referral hospitals for diagnosis, which may include biopsy and x-ray or ultrasound. When infection is detected early, there is a better chance of curing the disease before it causes lifelong harm and disability. Simple, effective, field-adapted diagnostic tests are urgently needed.
More information
Last updated: September 2025
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