A rare case of actinomycetoma

¹Department of Surgery, Sree Balaji Medical College and Hospital, Biher, Chennai, India, ²Department of Community Medicine, Sree Balaji Medical College and Hospital, Biher, Chennai, India

^&Corresponding author
Krishna Prasanth Baalann, Department of Community Medicine, Sree Balaji Medical College and Hospital, Biher, Chennai, India

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Actinomycetoma is a chronic, destructive infectious disease caused by actinomycetes that starts in the subcutaneous tissues and extends to the skin, deep tissues, and bone. A granulomatous inflammatory reaction in the deep dermis and subcutaneous tissue occurs as a result of this infection, which can spread to the underlying bone. Young adults in poor nations, especially men between the ages of 20 and 40, are particularly vulnerable. It has a triad of symptoms: a painless subcutaneous mass, multiple sinuses, and grainy discharge. A 43-year-old male patient came with complaints of painless mass in the right foot, associated with discharge from sinuses. There was a history of trauma while working in the farm, one year back, after which he developed a mass that gradually increased in size over time. On local examination of the Right foot, the mass was painless, firm with no noticeable lymphadenopathy. The mass was present over the dorsal aspect of the right feet, involving the little toe. Multiple discharging sinuses were present (A). All baseline investigations were done, and they showed up signs of infection. He was diagnosed with Actinomycetoma based on the clinical examination and gram stained smear report, which showed the presence of branched, gram positive filamentous rods consistent with actinomyces species. The patient was started on appropriate antibiotics and advised to come for regular follow up.

Figure 1: massive tumour-like lesion involving the little toe on the dorsum of right foot with multiple sinuses