Leucocyte chemotaxis to mycetoma agents--the effect of the antifungal drugs griseofulvin and ketoconazole.

Polymorphonuclear leucocytes are the predominant cell type in the inflammatory infiltrate around mycetoma grains. Human leucocyte chemotaxis using cells from healthy subjects has been demonstrated using cytoplasmic antigens from 3 mycetoma agents: Madurella mycetomatis and Pseudallescheria boydii, both fungi, and Streptomyces somaliensis, an actinomycete. There was a statistically insignificant increase in chemotaxis in the presence of ketoconazole, but griseofulvin was a potent inhibitor of leucocyte movement. Griseofulvin has been used to improve the clinical appearances in eumycetoma (fungal mycetoma) cases which respond poorly to antifungal chemotherapy and it is suggested that its effect in this condition depends, in part, on its ability to inhibit leucocyte aggregation around mycetoma grains.