A 50-year-old farmer from Maharashtra presents with a chronic swelling of the foot with multiple sinuses discharging yellow sulfur-like granules. Microscopy of the granules shows broad, branching fungal hyphae with chlamydospores. Which of the following is the MOST common cause of eumycetoma in India?

• A Madurella mycetomatis ✓
• B Nocardia brasiliensis
• C Actinomadura madurae
• D Streptomyces somaliensis

Explanation

Madurella mycetomatis is the most common cause of eumycetoma (fungal mycetoma) worldwide and in India, producing large dark (black-grain) granules. It shows broad septate fungal hyphae on microscopy, confirming its fungal (eumycotic) nature. Nocardia brasiliensis, Actinomadura madurae, and Streptomyces somaliensis cause actinomycetoma (bacterial/actinomycete), which also shows sinuses but with finer filamentous branching and different grain characteristics. The distinction between eumycetoma and actinomycetoma is clinically and therapeutically important.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.