{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T18:05:46Z","timestamp":1775844346226,"version":"3.50.1"},"reference-count":32,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Mycetoma is a chronic, destructive subcutaneous infection of fungal (eumycetoma) or bacterial (actinomycetoma) origin; predominantly affecting the extremities. Head and neck involvement is exceedingly rare, posing significant diagnostic and therapeutic challenges. Intractable cases are more difficult to manage, requiring alternative treatment strategies. We report the case of a 14-year-old girl with a 3-year history of ulcerating sinuses and nodules progressively spreading from the scalp and neck; to the upper back. Prior treatments with various antibiotics and antifungals provided no improvement. Histopathological analysis revealed neutrophilic inflammation and grains confirmed to be\n                    <jats:italic>Nocardia<\/jats:italic>\n                    species on Ziehl Nielsen staining. A combination of rifampicin and trimethoprim-sulfamethoxazole was initiated; resulting in remarkable clinical improvement and resolution of symptoms over 24 weeks. This case report demonstrates the efficacy of combining rifampicin and trimethoprim-sulfamethoxazole in managing rare, progressive case of head and neck mycetoma, especially where toxicity from established treatment regimen is feared. Future research should investigate optimal treatment durations and explore adjunctive therapies for mycetoma, particularly in resource-limited settings.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0299","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:32:38Z","timestamp":1764689558000},"page":"364-367","source":"Crossref","is-referenced-by-count":0,"title":["Successful Management of Progressive Mycetoma Affecting the Head and Neck"],"prefix":"10.4269","volume":"114","author":[{"given":"Aisha E.","family":"Sokunbi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Edo State University, Uzairue, Edo, Nigeria;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iriagbonse I.","family":"Osaigbovo","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, College of Medical Sciences, University of Benin, Benin City, Nigeria;"},{"name":"Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Indian J Dermatol","first-page":"332","article-title":"Mycetoma: An update","volume":"62","author":"Relhan","year":"2017"},{"key":"b2","series-title":"J Bone Jt Infect","first-page":"241","article-title":"Mycetoma caused by Madurella mycetomatis in immunocompromised patients \u2013 A case report and systematic literature review","volume":"7","author":"Hoogervorst","year":"2022"},{"key":"b3","series-title":"BMC Dermatol","first-page":"1","article-title":"Madurella mycetomatis infection of the foot: A case report of a neglected tropical disease in a non-endemic region","volume":"20","author":"Karrakchou","year":"2020"},{"key":"b4","series-title":"Isr Med Assoc J","first-page":"418","article-title":"Mycetoma of the foot caused by Madurella Mycetomatis in immigrants from Sudan","volume":"17","author":"Brufman","year":"2015"},{"key":"b5","series-title":"PLoS Negl Trop Dis","first-page":"e0010838","article-title":"Head and neck mycetoma: Clinical findings, investigations, and predictors for recurrence of the disease in Sudan: A retrospective study","volume":"16","author":"Omer","year":"2022"},{"key":"b6","series-title":"PLoS Negl Trop Dis","first-page":"e0003587","article-title":"Head and neck mycetoma: The mycetoma research centre experience","volume":"9","author":"Fahal","year":"2015"},{"key":"b7","series-title":"Oman Med J","first-page":"e111","article-title":"Successful treatment of recalcitrant actinomycetoma of gluteal area with combined medical treatment and surgical excision with graft reconstruction","volume":"35","author":"Al-Kathiri","year":"2020"},{"key":"b8","series-title":"Cochrane Database Syst Rev","first-page":"CD013082","article-title":"Drug therapy for Mycetoma","volume":"2018","author":"Scolding","year":"2018"},{"key":"b9","series-title":"Trans R Soc Trop Med Hyg","first-page":"117","article-title":"Mycetoma in children in Sudan","volume":"104","author":"Fahal","year":"2010"},{"key":"b10","series-title":"Indian J Paediatr Dermatol","first-page":"83","article-title":"Actinomycetoma in a child: A rare occurrence","volume":"23","author":"Yadav","year":"2022"},{"key":"b11","series-title":"Trans R Soc Trop Med Hyg","first-page":"328","article-title":"Mycetoma in West Africa","volume":"115","author":"Oladele","year":"2021"},{"key":"b12","series-title":"Res Rep Trop Med","first-page":"173","article-title":"Clinical features of mycetoma and the appropriate treatment options","volume":"12","author":"Agarwal","year":"2021"},{"key":"b13","series-title":"J Cytol Histol","first-page":"466","article-title":"Histopathological approach in diagnosis of mycetoma causative agents: A mini review","volume":"8","author":"Siddig","year":"2017"},{"key":"b14","series-title":"Antimicrob Agents Chemother","first-page":"e0161223","article-title":"Naphthylisoquinoline alkaloids: Novel agents against the causative pathogens of eumycetoma and actinomycetoma\u2013en route to broad-spectrum antimycetomal drugs","volume":"68","author":"Khalid","year":"2024"},{"key":"b15","series-title":"Indian J Dermatol Venereol Leprol","first-page":"166","article-title":"Treatment of actinomycetoma with combination of rifampicin and co-trimoxazole","volume":"74","author":"Joshi","year":"2008"},{"key":"b16","series-title":"Ann Clin Microbiol Antimicrob","first-page":"35","article-title":"Mycetoma: A clinical dilemma in resource limited settings","volume":"17","author":"Emmanuel","year":"2018"},{"key":"b1","series-title":"Indian J Dermatol","first-page":"332","article-title":"Mycetoma: An update","volume":"62","author":"Relhan","year":"2017"},{"key":"b2","series-title":"J Bone Jt 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