#IDFridays Week 19: Madura Foot

Very little is known about this disease which destroys skin, flesh, and bones

Name
Madura foot (also known as mycetoma)

The disease was first reported in the mid-19th century in the Indian town of Madura, which is where it gets its name

Transmission

A chronic, progressively destructive disease affecting the foot but can also affect other body parts including skin, flesh, and bones
Infection begins when fungi or ‎bacteria enter the body through an injury such as a thorn prick
- Scientists have discovered 7 types of bacteria and 18 types of fungus that can cause Madura foot
It cannot be transmitted from person-to-person
Commonly affects:
- Poor people in rural areas
- Young male adults between 20 and 40 years
- Manual workers (labourers, herdsmen, etc.)

Geography

The organisms that cause Madura foot can be found worldwide, but there is a ‘Mycetoma/Madura foot belt’ consisting of the following countries:

Venezuela, Chad, Ethiopia, India, Mauritania, Mexico, Senegal, Somalia, Sudan and Yemen

Incubation Period
Madura foot is a neglected tropical disease (NTD) and as such, there is little data on the incubation period

Signs and Symptoms

Painless masses on feet and other body parts
- Most commonly the extremities, back, and gluteal regions
- Discharge ‎containing grains coming from the masses
Can spread to the bone resulting in ‎destruction, ‎deformity and loss of function, which can lead to death
If untreated, a secondary bacterial infection can occur, leading to:
- Pain
- Disability
- Septicemia (fatal infection/blood poisioning involving the whole body)

Diagnosis

There are no simple diagnostic tests
Biopsies of the infected tissue and grains in the discharge are the most common ways to identify the disease
DNA sequencing is also possible

Treatment

There is no specific treatment for Madura foot as treatment depends on the cause and the affected areas
For bacterial infections, treatment usually consists of a combination of antibiotics used over a long period of time
For fungal infections, treatment can be a combination of surgery or amputation and antifungal drugs

Prognosis

Because Madura foot progresses slowly and is painless, many patients seek medical advice when it is too late and amputation is the only available treatment
Early detection and treatment help reduce morbidity and improve outcomes

Prevention: What Can You Do?

Preventing the infection is difficult as this is a neglected tropical disease (NTD)
When visiting affected areas and endemic countries, do not walk barefoot

Madura Foot In the News