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

Abstract

Mycetoma is a serious neglectedtropical disease, characterised by various disabilities and high morbidity.
Numerous causative organisms of fungal or bacterial origin are implicated in causing mycetoma. Accurate
identifcation 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 specifcity and not
available in the mycetoma endemic areas.
In this communication, we report the Mycetoma Research Centre (MRC), Khartoum, Sudan experience on
the fne needle aspiration for cytology (FNAC) technique for the identifcation of the mycetoma causative
organisms based on the cytological reports at the MRC Biobank in the period between 1991-2017. The
sensitivity and specifcity of the technique for the identifcation 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
identifcation 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.