Journal of Epidemiology and Public Health

Left Knee Mycetoma: A Rare Localization: A Case Report from the University Hospital "La Renaissance" In N"djamena and Literature Review

Abstract

Magloire Dingamnodji, Adoum Allamine H, Sidime S, Hounsou NR, Hassia C, Emery N, Ngamai K and Tall M

Introduction

Mycetomas are chronic, inflammatory, and often multi-fistulized pseudotumors of the skin, caused by exogenous fungi (eumycetomas) or aerobic bacteria (actinomycetes), and characterized by the production of grains. These are severe lesions, mostly seen in tropical and subtropical regions. Their management is challenging and can sometimes require radical treatment.

Case report We report the case of a 23-year-old male farmer with no known medical history, residing in Adré, a town located 1060 km from N›Djamena, the capital of Chad. He presented to the outpatient clinic with a painless swelling of the left knee evolving over four years. The patient reported a history of trauma from an acacia thorn prick. Clinical examination revealed a large, inflamed, polyfistulized knee with a “watering can” appearance. Upon pressure, multiple blackish grains of various sizes were visible to the naked eye. A diagnosis of left knee mycetoma with bone involvement was made. The patient underwent arthrotomy with sample collection and joint lavage, combined with antifungal treatment. The course was marked by recurrence, which required radical surgical intervention.

Conclusion This localization is particularly severe due to the near-systematic bone involvement

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