Le diagnostic biologique des mycétomes

Mycetoma is the pathologic process in witch exogenous fungal or actinomycotic agents generate grains. This chronic infection is observed in dry tropical aereas. The most frequent clinical feature is a subcutaneous tumor involving the foot. It is caracteristic when sinuses with discharging grains are observed. Biological diagnosis is somtimes difficult. However actinomycetoma and eumycetoma must be distinguished because of their completely different treatments. Direct examination and histopathologic features of grains and/or pus are usefull for type of the grains identification, giving a good orientation of the aetiological agent. However, usually, only fungal or bacterial cultures allows species identification. Eumycetoma cultures are often negatives. Molecular techniques have been successfully applied for identification of black grains mycetoma agents, for which fructification failed to be obtained. Serological tests are not used in routine diagnosis.