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Mode of infection is an inoculation of the causative microorganism <jats:italic>via<\/jats:italic> small injuries of the skin. The clinical correlate of both forms of mycetoma is tumescence with abscesses, painless nodules, sinuses and discharge. The latter is commonly serous\u2010purulent and contains grains (filamentous granules) which can be expressed for diagnostic purposes. Distinctive for both eumycetoma and actinomycetoma, are the formation of grains. Grains represent microcolonies of the microorganism <jats:italic>in vivo<\/jats:italic> in the vital tissue. The most successful treatment option for eumycetomas offers itraconazole in a dosage of 200\u00a0mg twice daily. This triazole antifungal is considered as \u2018gold standard\u2019 for eumycetomas. Alternatively, the cheaper ketoconazole was widely used, however, it was currently stopped by the <jats:styled-content style=\"fixed-case\">FDA<\/jats:styled-content>. Actinomycetomas should be treated by the combination of trimethoprim\u2010sulphamethoxazole (co\u2010trimoxazole 80\/400 to 160\/800\u00a0mg per day) and amikacin 15\u00a0mg\/kg body weight per day. Mycetomas are neglected infections of the poor. They are more than a medical challenge. In rural areas of Africa, Asia and South America mycetomas lead to socio\u2010economic consequences involving the affected patients, their families and the society in general.<\/jats:p>","DOI":"10.1111\/jdv.13008","type":"journal-article","created":{"date-parts":[[2015,2,27]],"date-time":"2015-02-27T15:51:43Z","timestamp":1425052303000},"page":"1873-1883","source":"Crossref","is-referenced-by-count":105,"title":["Eumycetoma and actinomycetoma \u2013 an update on causative agents, epidemiology, pathogenesis, diagnostics and therapy"],"prefix":"10.1111","volume":"29","author":[{"given":"P.","family":"Nenoff","sequence":"first","affiliation":[{"name":"Labor f\u00fcr medizinische Mikrobiologie Partnerschaft Prof. Pietro Nenoff &amp; Dr. Constanze Kr\u00fcger M\u00f6lbis Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.W.J.","family":"van de Sande","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology &amp; Infectious Diseases Erasmus MC Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.H.","family":"Fahal","sequence":"additional","affiliation":[{"name":"The Mycetoma Research Centre University of Khartoum Khartoum Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Reinel","sequence":"additional","affiliation":[{"name":"Hautarztpraxis Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Sch\u00f6fer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Dermatologie, Venerologie und Allergologie Klinikum der Johann Wolfgang Goethe\u2010Universit\u00e4t Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734612438549"},{"key":"e_1_2_12_3_1","unstructured":"NenoffP.Eumycetoma\/Myzetom. 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