A Surprise in the Left great toe

J Thanka,Jayashree B,G Barathi

doi:10.21276/apalm.1675

Abstract

Mycetoma is a chronic inflammatory disease affecting the subcutaneous tissue. It presents as a local swelling with discharging sinuses containing granules. Mycetoma or madura foot are fungal infections caused by true fungi (eumycetoma).The classical presentation of a mycetoma foot are painless subcutaneous lesion,multiple sinuses and seropurulent discharge containing grains. An accurate diagnosis is obtained by histopathological examination.Our case was a 60 year old male with left great toe swelling, a rare clinical presentation, incidentally diagnosed to have Madura foot (Eumycetoma).

Highlights

Mycetoma is chronic granulomatous, progressively inflammatory disease of the foot and can occur in any part of the body
The name as it is was first discovered in the mid 19th century in the famous city of Tamil Nadu, Madurai and it was previously known as Madura foot
Mycetoma is a chronic inflammatory disease, associated with a granulomatous reaction and occurs whenever there is an infection caused by either bacteria or fungi

Summary

Introduction

Progressively inflammatory disease of the foot and can occur in any part of the body. It is endemic in tropical and sub tropical regions. A 60 year old male patient came with complaints of swelling in the left great toe for a period of two months. On examination he had a single swelling on left great toe measuring 2x1cm.Clinically the working diagnosis of haemangioma /calcified cyst was made and microbiological or radiological investigation was not done for the patient. Haematoxylin and Eosin (H& E) sections from the skin and subcutaneous tissue showed multiple micro abscess with brown colour pigmented fungal colonies (fig 1& 2) with Splendore-. The patient has been advised for further follow up to asses the response of the treatment given and for further management

Findings

Discussion

Conclusion