Mycetoma.

The Neglected Tropical Disease mycetoma is a chronic, progressive infectious disease characterized by large tumor-like masses in subcutaneous tissues. It is endemic in rural areas of low- and middle-income countries, where it can lead to extensive health and socioeconomic burdens for the patient and their family. It is especially prevalent among male farmers. The disease can be caused by both bacteria and fungi, referred to as actinomycetoma and eumycetoma, respectively. Inoculation occurs when a skin breach allows the pathogen to enter the subcutaneous tissue. The pathogen can form grains, which make the disease more resistant to host defense and antimicrobial treatments. This review summarizes the current knowledge on the historical background and epidemiology of mycetoma, the characteristics of its causative agents, underlying pathophysiology, diagnostic approaches, available treatment strategies, preventive measures, and future prospects for disease management and research. Although the recognition of mycetoma as both a neglected tropical disease and a fungal priority pathogen has increased awareness and research interest, large knowledge gaps remain.