Mycetoma
ICD-10 B47 is a billable code used to indicate a diagnosis of mycetoma.
Mycetoma, also known as 'Madura foot', is a chronic granulomatous disease caused by a variety of fungi and bacteria, primarily affecting the skin, subcutaneous tissue, and bone. It is characterized by the formation of painless, swollen nodules that can eventually lead to deformity and disability if left untreated. The condition is endemic in tropical and subtropical regions, often associated with agricultural activities where individuals are exposed to soil and plant material. The causative agents include fungi such as Acremonium, Pseudallescheria, and Madurella, as well as actinomycetes like Nocardia and Streptomyces. Diagnosis is typically made through clinical examination, imaging studies, and microbiological culture of the organism. Treatment involves antifungal or antibacterial medications, depending on the causative organism, and may require surgical intervention for extensive disease. Immunocompromised patients are at higher risk for severe manifestations of mycetoma, necessitating careful management and monitoring.
Detailed history of exposure, laboratory results, and treatment plans.
Patients presenting with chronic skin lesions, especially in endemic areas.
Need for comprehensive microbiological workup to identify the specific pathogen.
Clinical photographs, biopsy results, and treatment response documentation.
Patients with chronic nodular lesions on the extremities.
Differentiation from other dermatological conditions such as sarcoidosis or leprosy.
When a biopsy is performed to confirm mycetoma.
Pathology report detailing the organism and histological findings.
Ensure the biopsy is documented as related to mycetoma.
The primary treatment for mycetoma involves antifungal medications such as itraconazole or terbinafine, and in some cases, surgical intervention may be necessary.
Mycetoma can be differentiated based on its chronic presentation, the presence of grains in discharge, and specific microbiological culture results.
