Mitsetoma is the chronic purulent infection affecting leather, hypodermic cellulose and bones, widespread in tropical and subtropical regions.
The most ancient description of this disease goes back to the Old Indian Sanskrit text "Atkharva Veda" in whom a reference on padavalmika is made that means "ant hill". In more modern times Gill for the first time recognized mitsety as a disease in 1842. The southern province of Madura from where the name "leg of Madura" is widespread. Godfrey for the first time documented a mitsetoma case in Madras, India. However the term "mitsetom" (meaning a fungal tumor) was offered by Carter who established a fungal etiology of this frustration. It classified the affairs on color of grains. Later, Pina acknowledged the possibility of classification of cases of a mitsetoma by group of causal organisms, both Chalmers and Archibald created formal classification which divided them into two groups.
Mitsetoma are caused by different types of mushrooms and bacteria which meet in the form of saprofit in the soil or on plants. The Aktinomikotichesky mitsetoma is caused by the most widespread aerobic species of the actinomycetes belonging to the sorts Nocardia, Streptomyces and Actinomadura among which there is Nocardia brasiliensis, Actinomadura madurae, Actinomadura pelletieri and Streptomyces somaliensis.
The Eumikotichesky mitsetoma is connected with a set of mushrooms, the most widespread of which is Madurella mycetomatis.
It is reported that the mitsetoma meets around the world. It is endemic in tropical and subtropical regions, especially between latitudes 15–30 ° northern latitude, also known as "a mitsetoma belt" (Sudan, Somalia, Senegal, India, Yemen, Mexico, Venezuela, Colombia and Argentina); however the actual endemic area goes beyond this belt. The majority of cases is registered in Sudan and Mexico, and Sudan is the most endemic country. The types causing to mitsety vary from the country to the country, and activators which are more widespread in one region, seldom meet in other areas. Around the world M. Mycetomatis is the most common cause of this illness. A. madurae, M. mycetomatis and S. somaliensis meet more often in drier regions whereas Pseudallescheria boydii, types of Nocardia and A. pelletieri meet in areas with higher annual amount of precipitation more often. In India, types of Nocardia and Madurella grisea are the most common causes of a mitsetoma.
In general, the majority of cases occurs in droughty and hot climate which has the short period of heavy rains with softer temperatures. Aktinomitsetoma meets more often in drier areas whereas the eumitsetoma meets in places with a large amount of precipitation more often.
About 75% mitsety are aktinomikotichesky in some parts of India. Nevertheless, the eumikotichesky mitsetoma makes the majority of the cases registered in the northern region. About a mitsetoma to a thicket it is reported at men, than at women (3:1) probably it is connected with the fact that men participate in agricultural works more often. This disease most often occurs in young people and seldom occurs in children.
Though antibodies against the activator are found in a number of people, only at the few the disease develops, and it can be connected with difficult interaction of factors between the owner and a pathogen.
The organism, as a rule, is implanted after the getting trauma when performing agricultural works barefoot or through earlier existing grazes. Increase in quantity in tropical regions can be connected with reduction of use of protective clothes, generally footwear and also because of warmer and bad conditions. Some contributing states, such as bad general state of health, diabetes and malnutrition can be usually found, and it can lead to more invasive and widespread infection. It was shown that the complement - dependent hemotaxis polimorfnoyaderny leukocytes is induced by both fungal, and aktinomikotichesky in vitro antigens. Cages of the congenital immune system try to absorb and inactivate these organisms, but at a disease finally do not achieve this objective.