2128 



MYCETOMA AND PARAMYCETOMA 



numerous plasma cells and occasionally giant cells; there is a 

 marked proliferation of bloodvessels. 



Symptomatology. — The disease usually begins in the foot, more 

 rarely in the hand, and still more rarely in the leg, knee, neck, or 

 trunk. There may or may not be a history of ja cut or injury some 

 time previously. In any case, this primary injury will have healed 

 long before the disease is well established. 



The incubation period in well-recorded^cases would appear to 

 be short ; thus, in Musgrave and Clegg's case, one month after the 



Fig. 847. — Mycetoma. 



primary injury the wound reopened and discharged pus, and in 

 their experiments on monkeys it appeared to vary from ten to 

 sixteen days. Further researches on this point are, however, 

 required. 



The earliest signs are either pain or swelling in the region of the 

 original injury, which is usually on the sole of the foot, between the 

 toes, or on the instep. The swelling becomes a hard lump, on the 

 surface of which a bleb may form, which bursts and reveals a small 

 opening discharging an oily, rarely sanious, thin, offensive pus, in 

 which the granules characteristic of the fungus may be found. 



