Painful mycetoma: a study to understand the risk factors in patients visiting the Mycetoma Research Centre (MRC) in Khartoum, Sudan

Background: Mycetoma, a neglected tropical disease endemic to Sudan, is traditionally characterized as a painless condition. However, recent studies reporting painful mycetoma lesions have challenged this assumption. With limited reports in the medical literature regarding pain in mycetoma, this study was conducted to investigate the risk factors for painful mycetoma lesions in patients visiting the Mycetoma Research Centre (MRC) in Khartoum, Sudan.

Methods: This cross-sectional study aimed to identify the risk factors for painful mycetoma lesions. The study analyzed electronic records of 481 patients with confirmed mycetoma, seen between 1991 and 2020, using a systematic sampling approach.

Results: The study found that pain was more likely to occur in cases with bone destruction, secondary bacterial infection and actinomycete infection (OR=1.762, 1.815 and 1.259, respectively). Additionally, pain was more frequently observed in patients aged 45 y and older. Smaller mycetoma lesions, measuring less than 5 cm, were less likely to cause pain, and this was identified as a significant risk factor for painful mycetoma lesions (β coefficient=-1.294).

Conclusion: The findings suggested that pain in mycetoma is typically associated with the severity of the condition. Therefore, early initiation of appropriate treatment may help reduce pain. Furthermore, careful differentiation between actinomycetes and eumycetes is essential for the timely and accurate diagnosis of mycetoma.