(described by Brumpt in 1905)
Taxonomic Classification
Kingdom: Fungi
Phylum: Ascomycota
Class: Euascomycetes
Order: Dothideales
Family: Lophiostomataceae
Genus: Madurella
Description and Natural Habitats
Madurella is a dematiaceous (phaeoid, or dark-walled) filamentous fungus found in soil, particularly in tropical and subtropical areas of Africa, India, and South America. The members of this genus don’t have any known teleomorphs. Madurella is pathogenic for humans and causes infections.
Species
The genus Madurella has two species; Madurella mycetomatis and Madurella grisea. See the summary of synonyms for the Madurella spp.
Pathogenicity and Clinical Significance
Madurella spp. are among the causative agents of human mycetoma. Strains belonging to this genus are isolated specifically from cases with black-grain eumycetoma. The fungus enters the human body via trauma and the progression of mycetoma is very slow which may take several years. Mycetoma remains localized and involves the cutaneous and subcutaneous tissues, the fascia, and the bones. Tumefaction and draining sinuses are typical [1486].
Macroscopic Features
Madurella colonies grow slowly. Madurella mycetomatis grows well at 37°C while Madurella grisea grows poorly or does not grow at all at this temperature.The texture of the colonies is glabrous to wooly. They are raised to heaped and sometimes radially folded. From the front, the color varies from white to yellow-brown, dark gray or olive brown. From the reverse, it is dark brown. Occasionally, a brownish diffusible pigment may also be produced [531, 1295, 2144].
Microscopic Features
Septate hyphae, chlamydospores, and sclerotia (large and black masses of hyphae) are observed. Madurella strains are dematiaceous and sterile under laboratory conditions. However, occasional isolates of Madurella mycetomatis may form phialides having collarettes in the laboratory. These phialides bear round or oval conidia at their tips [531, 1295, 2144].
Histopathologic Features
Phaeoid granules composed of hyphae are observed. See our histopathology page.
Laboratory Precautions
No special precautions other than general laboratory precautions are required.
Susceptibility
Very limited data are available. In a previous in vitro assay, ketoconazole and itraconazole MICs appeared to be lower than those of econazole and miconazole [2313]. In a more recent study, voriconazole
MICs were found to be considerably low, while those of itraconazole were variable [1864].
For MICs of various antifungal drugs for Madurella, see our N/A(L):susceptibility database.
A combination of antifungal and surgical therapy is usually preferred for treatment of cases with mycetoma. Ketoconazole yields favorable response rates when used for polonged durations of as long as 8 to 24 months. Griseofulvin may be used in patients who do not respond to ketoconazole [1413, 1486, 2312].