The disease is listed by the World Health Organization (WHO) as a neglected tropical disease. Risk
Frequent exposure to penetrating wounds by thorns or splinters is a risk factor. This risk can be reduced by disinfecting wounds and wearing shoes. Pathogenesis
Mycetoma is caused by common saprotrophs found in the soil and on thorny shrubs in semi-desert climates. Some common causative agents are:
Madurella mycetomatis (fungus)
Nocardia brasiliensis (bacteria)
Actinomadure madura (bacteria)
Streptomyces somaliensis (bacteria)
Actinomadura pelletieri (bacteria)Infection is caused as a result of localized skin trauma, such as stepping on a needle or wood splinter, or through a pre-existing wound.The first visible symptom of mycetoma is a typically painless swelling beneath the skin; over several years, this will grow to a nodule (lump). Affected people will experience massive swelling and hardening of the area, in addition to skin rupture and the formation of sinus tracts that discharge pus and grains filled with organisms. In many instances, the underlying bone is affected. Some people with mycetoma will not experience pain or discomfort, while others will report itching and/or pain. Diagnosis
There are currently no rapid diagnostic tools for mycetoma. Mycetoma is diagnosed through microscopic examination of the grains in the nodule and by analysis of cultures. Since the bacterial form and the fungal form of mycetoma infection of the foot share similar clinical and radiological features, diagnosis can be a challenge. Magnetic resonance imaging is a very valuable diagnostic tool. However, its results should be closely correlated with the clinical, laboratory and pathological findings.
Eosinopenia is a form of agranulocytosis where the number of eosinophil granulocytes is lower than expected. Leukocytosis with eosinopenia can be a predictor of bacterial infection. It can be induced by stress reactions, Cushings syndrome, or the use of steroids. Pathological causes include burns and acute infections. See also
Eosinophilia
Hypereosinophilia

References
Further reading
Krause JR, Boggs DR (1987). "Search for eosinopenia in hospitalized patients with normal blood leukocyte concentration". Am. J. Hematol. 24 (1): 55–63. doi:10.1002/ajh.2830240108. PMID 3799595. S2CID 20021710. == External links ==