Mycetoma in children in Sudan.

We report on 722 children with confirmed mycetoma seen at the Mycetoma Research Centre, Khartoum, Sudan during May 1991 to March 2009. There were 531 males (73.5%) and 191 females (26.5%) with an age range of 4-17 years (mean 13.7+/-2.9 years); most were students. The majority of patients were from Central and Western Sudan. The disease duration ranged between 6 months and 14 years (mean 2.27+/-2.12 years). Most of the patients had eumycetoma (79.1%). The clinical course was typical in the majority of the patients. Family history of mycetoma was reported in 15% of patients. The foot was affected most, followed by knee, hand, head and neck, chest wall and buttocks. In the foot, the metatarsal bones and calcaneum were affected most. Cytological and ultrasonic examinations of the lesions and histological examination of the surgical biopsies were the cornerstone in the diagnosis of mycetoma. Combined medical treatment and surgical excision was the standard treatment. Disease recurrence after surgical excision was reported in 17.9% of patients. The morbidity rate in this study was high, and it had led to high school dropout and many socioeconomic impacts on patients, families and community. Children with mycetoma need psychological support to identify and to treat their psychosocial problems. Copyright 2009 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.