Abstract

*Dr. Zeineb Alaoui Kadiri, L. Tahiri, F. Allali and H. Rkain

ABSTRACT

Mycetoma, commonly known as Madura foot, represents a rare yet challenging granulomatous pathology affecting subcutaneous tissues. This condition, caused by fungi, notably Madurella mycetomi, or actinomycetes like Nocardia brasiliensis, manifests primarily in the feet, earning its distinctive name. The gravity of Madura foot lies in tissue necrosis and its proclivity to involve the underlying skeleton, presenting as osteitis on radiographs. The diagnostic criteria encompass a specific clinical triad: swelling, abscess formation, and fistulization, accompanied by the discharge of grains with varying shades of brown or red, depending on their nature. Microscopic examination of these grains, along with cultural analysis, plays a pivotal role in confirming the diagnosis. While medical intervention, specifically sulfone-based treatments, demonstrates efficacy in the cure of actinomycotic mycetomas, surgical procedures remain foundational in addressing fungal mycetomas. Prophylactic measures involve wound disinfection and the use of suitable footwear. Despite these efforts, the prognosis, especially in cases of fungal infections, remains discouraging. Our case study revolves around a 49-year-old man with a history of a fractured ankle, presenting a complex manifestation of Madura foot, including swelling, fistulization, and the emission of black grains, indicative of an underlying skeletal involvement.