The New Molecular Generation Diagnosis of Mycetoma: A case report and literature review.

Mycetoma is a neglected tropical disease listed by the World Health Organization characterized by non‐contagious chronic infection of the skin and subcutaneous tissue which can involve structures like the fasciae, muscles, and bones; it usually begins after traumatic implantation of bacteria(actinomycetes) or fungal(eumicetomas) spores; has a high morbidity and and usually due to visceral involvement. Although is not endemic in the US, the continual influx of immigrants from areas where the disease is endemic creates a need for education regarding the clinical presentation and diagnosis In general, clinical evaluation is not very reliable; culture methods are still considered to be the gold standard in species identification of the causal agents of mycetoma; however, some agents are difficult to identify by morphology alone Discussion: Molecular methods have been developed for reliable identification of causal agents to the genera Actinomadura, Nocardia and Streptomyces based on DNA deep sequencing on 16S‐rRNA (ribosomal ribonucleic acid gene. Recent studies showed presented new genome analysis for identification of eumycetoma methods based on PCR, internal transcribed spacer(ITS),Rolling Circle Amplification (RCA)and the Loop‐mediated Isothermal Amplification. In the present case, the DNA deep‐sequencing combined with conventional methods proved a better case management and treatment. The total remission with carbapenes proved that the correct course of diagnosis was chosen We present one case of pedal mycetoma and review new developments in molecular diagnosis of Mycetoma.