Fine needle aspiration cytology utility in the identification of Mycetoma causative agents: The Mycetoma Research Center experience.

Sahar Mubarak Bakhiet, Emmanuel Edward Siddig, Omnia Babekir Abdallah, EL Samani Wadaa Mohamed, Ahmed Hassan Fahal

Abstract


Mycetoma is a serious neglected tropical disease, characterised by various disabilities and high morbidity. Numerous causative organisms of fungal or bacterial origin are implicated in causing mycetoma. Accurate identification of the causative organism is mandatory for proper treatment and management.  Currently, the available diagnostic tests for mycetoma are invasive, tedious, of low sensitivity and specificity and not available in the mycetoma endemic areas. In this communication, we report the Mycetoma Research Centre (MRC), Khartoum, Sudan experience on the fine needle aspiration for cytology (FNAC) technique for the identification of the mycetoma causative organisms based on the cytological reports at the MRC Biobank in the period between 1991-2017. The sensitivity and specificity of the technique for the identification of Madurella mycetomatis was 88.7% and 57.3 %, respectively. For Actinomadura madurae it was 28.7% and 96.6%, respectively. Furthermore, it was 74.1% and 88.9%, respectively for Streptomyces somaliensis and 46.7% and 99.5%, respectively for Actinomadura pelletieri. From this study, it can be concluded that the technique is reasonably accurate in the identification of mycetoma causative organisms, rapid, minimally invasive, and cost-effective procedure. It can be used for the diagnosis of mycetoma in rural areas. The use of the ultrasound-guided aspiration may improve its accuracy

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