What is it about?
Mycetoma is a chronic skin and tissue infection caused by fungi or bacteria, recognized as a neglected tropical disease by the WHO. Although well-studied in Africa and India, data from Southeast Asia are scarce. We reviewed 25 years of cases in southern Thailand and found that the disease here is caused by a diverse range of fungi — unlike the rest of the world where one species dominates. Despite combined drug treatment and surgery, only about half of patients were cured, highlighting the need for better diagnostics and region-specific treatment strategies in Southeast Asia
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Why is it important?
This is the largest study of mycetoma from Southeast Asia to date, covering 25 years of cases. We show that mycetoma in southern Thailand is caused by a distinctly different range of fungi compared to classical endemic regions, where a single species predominates globally. This has direct implications for how clinicians in the region should approach diagnosis and treatment. Our findings challenge the assumption that global mycetoma guidelines apply universally, and underscore the need for region-specific neglected tropical disease strategies in Southeast Asia.
Perspectives
Mycetoma is a disease that most physicians in Thailand, and Southeast Asia more broadly, rarely encounter or think about. Working on this study gave me a deeper appreciation of how much we still have to learn about neglected tropical diseases in our own region. I hope this work encourages clinicians here to consider mycetoma earlier in patients with chronic foot swelling, and motivates researchers across Southeast Asia to build the diagnostic capacity and regional data that this disease truly deserves.
Nonthanat Tongsengkee
Prince of Songkla University
Read the Original
This page is a summary of: Clinical presentation, etiology, and treatment outcomes of mycetoma: A 25-year retrospective study in Southern Thailand, PLoS Neglected Tropical Diseases, January 2026, PLOS,
DOI: 10.1371/journal.pntd.0013818.
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