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A 24-year-old girl, without any significant medical history. with seven months' history of a painful tumefaction of her left foot. Physical examination revealed a tumefaction that discharges a purulent exudate containing black granules via skin fistulas. Direct microscopic examination of grains suggests a fungal infection. Standard X-rays of his foot showed no lesion of the bone. So with the combination of the clinical specific lesions and typical grains, a diagnosis of Madura foot was made and the patient treated with surgical debridement, followed by Ketoconazole for 12 months, she is under regular monitoring. Mycetoma is characterized by a clinical triad of chronic induration, draining sinuses and discharge of granules. It is either actinomycotic or eumycotic in etiology. It is endemic in tropical and subtropical countries.
Figure 1.
(A) tumefaction of the left foot discharging black grains; (B) black eumycetoma grains; (C) standard X-rays showed no bone lesion; (D) surgical debridement