Advanced eumycetoma with intracranial extension in three Sudanese patients: a case series and review of the literature

Abstract

BACKGROUND: Eumycetoma is an endemic chronic granulomatous infection in tropical and subtropical regions, including Sudan. CASE PRESENTATION: This case series presents three Sudanese patients with intracranial mycetoma (27-year-old female from Central Sudan, 20-year-old male from Central Sudan, and 23-year-old male from West Sudan), highlighting different clinical presentations, diagnostic challenges, and management strategies. All cases involved young individuals with painless swellings, discharging sinuses, and other central nervous system manifestations. The diagnosis was confirmed by different histopathological and imaging modalities. Surgical management was performed for the localized lesion case but, unfortunately, the other two cases were difficult to operate on owing to the large extension of the disease and were followed with medical management. CONCLUSION: This series highlights the difficulties in diagnosing and managing cases of intracranial mycetoma. It emphasizes the importance of early diagnosis, multidisciplinary management, and public health efforts to reduce the burden of mycetoma in endemic regions.