• 1

    Gams W, McGinnis M: Phialemonium, a new anamorph genus intermediate between Phialophora and Acremonium. Mycologia 75: 977, 1983.

  • 2

    Guarro J, Nucci M, Akiti T, et al: Phialemonium fungemia: two documented nosocomial cases. J Clin Microbiol 37: 2493, 1999.

  • 3

    Klokke A, Swamidasan G, Anguli R, et al: The causal agents of mycetoma in south India. Trans R Soc Trop Med Hyg 62: 509, 1968.

  • 4

    Camarota S, Zeigler K: Immigrants in the United States 2016. A profile of the foreign-born using 2014 and 2015 Census Bureau Data. Available at https://cis.org/sites/cis.org/files/immigrant-profile_0.pdf. Accessed November 19, 2018.

    • Search Google Scholar
    • Export Citation
  • 5

    McGinnis MR, Gams W, Goodwin MN: Phialemonium obovatum in a burned child. J Med Vet Mycol 24: 51, 1986.

  • 6

    King D, Pasarell L, Dixon DM, et al: A phaeohyphomycotic cyst and peritonitis caused by Phialemonium species and a reevaluation of its taxonomy. J Clin Microbiol 31: 1804, 1993.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7

    Wood C, Russel-Bell B: Characterization of pigmented fungi by melanin staining. Am J Dermatopathol 5: 77, 1983.

  • 8

    De Hoog GS, Guarro J, Gene J, et al: Atlas of Clinical Fungi, 2nd ed. Contraalbureau voor Schimmelcultures, Utrecht, The Netherlands, 2000.

    • Search Google Scholar
    • Export Citation
  • 9

    Rivero M, Hidalgo A, Alastruey-Izquierdo A, et al: Infections due to Phialemonium species: case report and review. Med Mycol 47: 766, 2009.

  • 10

    Sigler L: “Miscellaneous opportunistic fungi: Microascaceae and other ascomycetes, hyphomycetes, coelomycetes and basidiomycetes,” in Pathogenic Fungi in Humans and Animals, edited by DH Howard, p 637, Marcel Dekker, New York, 2003.

    • Search Google Scholar
    • Export Citation
  • 11

    Abbott P: Mycetoma in the Sudan. Trans R Soc Trop Med Hyg 50: 11, 1956.

  • 12

    Ching BY, Maraczi G, Urbina D: Madura foot: a case presentation. JAPMA 81: 443, 1991.

  • 13

    Zaios N, Teplin D, Rebel G: Mycetoma. Arch Dermatol 99: 215, 1969.

  • 14

    Simpson A, Singh SR: A case of Madura foot. J R Coll Surg Edinb 29: 326, 1984.

  • 15

    Ahmed A, Leeuwen W, Fahal A, et al: Mycetoma caused by Madurella mycetomatis: a neglected infectious burden. Lancet 4: 566, 2000.

  • 16

    Sarris I, Berendt AR, Athanasous N, et al: MRI of mycetoma of foot: two cases demonstrating the dot-in-circle sign. Skeletal Radiol 32: 179, 2003.

  • 17

    Davis JD, Stone SP, McGarry JJ: Recurrent mycetoma of the foot. J Foot Ankle Surg 38: 55, 1999.

  • 18

    Mercut D, Tita C, Ianosi G, et al: Madura's foot (mycetoma). Chirurgia 98: 261, 2003.

  • 19

    Mostert L, Groenewald JZ, Summerbell RC, et al: Species of Phaeoacremonium associated with infections in humans and environmental reservoirs in infected woody plants. J Clin Microbiol 43: 1752, 2005.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Guarro J, Alves SH, Gene J, et al: Two cases of subcutaneous infection due to Phaeoacremonium spp. J Clin Microbiol 41: 1332, 2003.

  • 21

    Baradkar VP, Mathur M, Kumar S: Phaeohyphomycosis of subcutaneous tissue caused by Phaeoacremonium parasiticum. Indian J Med Microbiol 27: 66, 2009.

  • 22

    Padhye AA, Davis MS, Baer D, et al: Phaeohyphomycosis caused by Phaeoacremonium inflatipes. J Clin Microbiol 36: 2763, 1998.

  • 23

    Naggie S, Perfect JR: Molds: hyalohyphomycosis, phaeohyphomycosis, and zygomycosis. Clin Chest Med 30: 337, 2009.

  • 24

    Kumar KK, Hallikeri K: Phaeohyphomycosis. Indian J Pathol Microbiol 51: 556, 2008.

  • 25

    Venkatswami S, Sankarasubramanian A, Subramanyam S: The Madura foot: looking deep. Int J Low Extrem Wounds 11: 31, 2012.

  • 26

    Zein HAM, Fahal AH, Mahgoub ES, et al: The predictors of cure, amputation and follow-up dropout among mycetoma patients as seen at the Mycetoma Research Centre, University of Khartoum, Sudan. Trans R Soc Trop Med Hyg 106: 639, 2012.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27

    Heath CH, Lendrum JL, Wetherall BL, et al: Phaeoacremonium parasiticum infective endocarditis following liver transplantation. Clin Infect Dis 25: 1251, 1997.

  • 28

    Fahal AH, Hassan MA: Mycetoma. Br J Surg 79: 1138, 1992.

  • 29

    Mahgoub ES, Gumaa SA: Ketoconazole in the treatment of eumycetoma due to Madurella mycetomii. Trans R Soc Trop Med Hyg 78: 376, 1984.

  • 30

    Venugopal PV, Venugopal TV: Treatment of eumycetoma with ketoconazole. Australas J Dermatol 34: 27, 1993.

  • 31

    Smith EL, Kutbi S: Improvement of eumycetoma with itraconazole. J Am Acad Dermatol 36: 279, 1997.

  • 32

    Castro LGM, Piquero-Casals J: Clinical and mycologic findings and therapeutic outcome of 27 mycetoma patients from Sao Paulo, Brazil. Int J Dermatol 47: 160, 2008.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33

    N'Diaye B, Dieng MT, Perez A, et al: Clinical efficacy and safety of oral terbinafine in fungal mycetoma. Int J Dermatol 45: 154, 2006.

  • 34

    Mhmoud NA, Fahal AH, Mahgoub el S, et al: The combination of amoxicillin-clavulanic acid and ketoconazole in the treatment of Madurella mycetomatis eumycetoma and Staphylococcus aureus co-infection. PLoS Negl Trop Dis 8: e2959, 2014.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    Revankar SG, Sutton DA: Melanized fungi in human disease. Clin Microbiol Rev 10: 884, 2010.

  • 36

    Ashbee HR, Barnes RA, Johnson EM, et al: Therapeutic drug monitoring (TDM) of antifungal agents: guidelines from the British Society for Medical Mycology. J Antimicrob Chemother 69: 1162, 2014.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Fahal AH, Rahman IA, El-Hassan AM, et al: The safety and efficacy of itraconazole for the treatment of patients with eumycetoma due to Madurella mycetomatis. Trans R Soc Trop Med Hyg 105: 127, 2011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Fahal AH, El Hassan MA, Sanhouri M: Surgical treatment of mycetoma. Sudan Med J 32: 92, 1994.

  • 39

    Lewis RE. Current concepts in antifungal pharmacology. Mayo Clin Proc 86: 805, 2011.

  • 40

    Mollica PW, Brenner MA, Nair SR, et al: Madura foot: a case report. Cutis 27: 634, 1981.

Immigration Brings New Pathology with No Standardized Treatment Protocol

Madura Foot Case Studies Phialemonium and Phaeoacremonium

Tara L. Harrington Intermountain Medical Center Surgery, Salt Lake City, UT. Dr. Harrington is now with the Northern Ohio Foot and Ankle Foundation Reconstruction Fellowship, Concord, OH.

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Denten Eldredge Western University of Health Sciences, College of Podiatric Medicine, Pomona, CA. Dr. Eldredge is now with Reconstruction Foot and Ankle, Department of Orthopedics, Podiatry, and Sports Medicine, Kaiser Permanente Central Valley Region, Stockton, CA.

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Erica K. Benson St. Mary's Medical Center, San Francisco, CA.

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Madura foot is an uncommon invasive soft-tissue infection that foot and ankle specialists encounter. We present two rare cases of Phialemonium and Phaeoacremonium fungi infections of the foot diagnosed in northern California to inform physicians on the presentation and current treatment options for this unique pathology. The two cases presented outline the clinical presentations, diagnostic data, and surgical and antimicrobial interventions. There is a concentration on the antimicrobial options depending on which of the over 20 species is encountered. The pertinent literature and supporting data are reviewed to create an outline for discussion of treatment protocols when faced with these emerging opportunistic infections.

Corresponding author: Tara L. Harrington, DPM, MBA, MHA, Northern Ohio Foot and Ankle Foundation Reconstruction Fellowship, 38401 Mentor Ave, Unit 1204, Willoughby, OH 44094. (E-mail: t.harrington.dpm@gmail.com)