{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:07:22Z","timestamp":1789556842341,"version":"build-2803163510"},"update-to":[{"DOI":"10.1371\/journal.pntd.0010607","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000}}],"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"No funding"},{"name":"no funding"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Mycetoma is an important neglected tropical disease associated with debilitation, disfigurement and death if not diagnosed and treated adequately. In Pakistan, mycetoma cases have frequently been diagnosed in histopathology and microbiology laboratories. However, there is scarcity of published data from this country. Therefore, the objectives of this study were to evaluate the frequency and type of mycetoma reported in skin and soft tissue biopsies from a single center over 10 years and review of published literature from Pakistan.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>This descriptive observational retrospective study was conducted at the Aga Khan University Hospital laboratory, Karachi, Pakistan. Laboratory data from 2009\u20132018 of skin and soft tissue biopsies with positive findings of mycetoma were retrieved from hospital information system. The variables for statistical analysis were age and gender of patient, anatomical site of lesion, residence of patient (geographical location) in the country, etiologic agents of mycetoma and significant gross and microscopic histopathological findings. The data was entered, and descriptive epidemiologic assessment was carried out using MS excel 2013. Geographical information system was used for mapping the location. Literature review of mycetoma cases reported from Pakistan was done on PubMed, Google search and PakMediNet from 1980 till April 2019.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Result<\/jats:title>\n<jats:p>During ten years of study period, 89 skin and soft tissue biopsies were reported as mycetoma, majority were eumycetoma [n = 66\/89 (74%)] followed by actinomycetoma [n = 23\/89 (26%)]. Involvement of lower limb was predominantly observed [n = 74\/89 (83%)] in which foot had significant contribution [n = 65\/74 (88%)]. Only 18 specimens were submitted for microbiological assessment and six grew agents of mycetoma, with <jats:italic>Madurella mycetomatis<\/jats:italic> reported in only three. Well-formed granuloma formation was observed in only 26%[n = 23\/89] of cases. Specific geographical location was not identified, and cases were reported from across the country. From Pakistan, only two original papers and 7 case reports were available in published literature.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This single center study reports a handful of cases of mycetoma from Pakistan. We conclude that the index of suspicion should remain high among treating surgeons and physicians and clinical laboratories should improve their diagnostic capacity and skills. This will have a great impact on disease outcome and patient\u2019s life.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010607","type":"journal-article","created":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T17:43:10Z","timestamp":1659116590000},"page":"e0010607","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Reporting of mycetoma cases from skin and soft tissue biopsies over a period of ten years: A single center report and literature review from Pakistan"],"prefix":"10.1371","volume":"16","author":[{"given":"Mohammad","family":"Zeeshan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saira","family":"Fatima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joveria","family":"Farooqi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kauser","family":"Jabeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsalan","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afreen","family":"Haq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Omer","family":"Arif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afia","family":"Zafar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"issue":"1","key":"pntd.0010607.ref001","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/S1473-3099(15)00359-X","article-title":"Mycetoma: a unique neglected tropical disease","volume":"16","author":"EE Zijlstra","year":"2016","journal-title":"The Lancet Infectious Diseases"},{"issue":"11","key":"pntd.0010607.ref002","doi-asserted-by":"crossref","first-page":"e2550","DOI":"10.1371\/journal.pntd.0002550","article-title":"Global burden of human mycetoma: a systematic review and meta-analysis","volume":"7","author":"WW Van De Sande","year":"2013","journal-title":"PLoS neglected tropical diseases"},{"issue":"49","key":"pntd.0010607.ref003","first-page":"661","article-title":"Weekly Epidemiological Record, 2018, vol. 93, 49 [full issue]","volume":"93","author":"mondiale de la Sant\u00e9 O, Organization WH","year":"2018","journal-title":"Weekly Epidemiological Record = Relev\u00e9 \u00e9pid\u00e9miologique hebdomadaire"},{"issue":"11","key":"pntd.0010607.ref004","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1111\/j.1365-4632.2010.04610.x","article-title":"Mycetoma in South India: retrospective analysis of 13 cases and description of two cases caused by unusual pathogens: Neoscytalidium dimidiatum and Aspergillus flavus","volume":"49","author":"S Padhi","year":"2010","journal-title":"International journal of dermatology"},{"issue":"3","key":"pntd.0010607.ref005","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s11046-007-9066-z","article-title":"Mycetomas in Iran: a review article","volume":"165","author":"A Zarei Mahmoudabadi","year":"2008","journal-title":"Mycopathologia"},{"issue":"5","key":"pntd.0010607.ref006","doi-asserted-by":"crossref","first-page":"529","DOI":"10.4103\/0019-5154.139889","article-title":"Mycetoma in Iran: causative agents and geographic distribution","volume":"59","author":"S. 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