Mycetoma / Madura Foot

Localised destructive infection of skin and subcutaneous tissue – can invade deeper tissues.
70% affect the foot (Madura- state in India).

Due to filamentous bacteria, aerobic actinomycetes (actinomycetomas) and true fungi (eumycetoma). More common in dry, tropical and rural areas.
Most common organisms are Pseudallescheria boydii (USA); Madurella mycetomatis (Africa); Nocardia brasiliensis (Latin America); Streptomyces samaliensis (Middle East).

Clinical features
Localised painless infection with some soft tissue swelling of foot
Three characteristics:
1) Nodules at sit of inoculation
2) Purulent drainage and fistula formation
3) Grains/granules present in drainage
In later stages, marked swelling and pain

- Antifungal therapy guided by culture sensitivity

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