A farmer in Maharashtra presents with a painless nodular lesion on the foot with discharging sinuses and black granules. Histopathology shows fungal grains with brown-black melanin pigment. What is this condition called and which organism most commonly causes it in India?

• A Eumycetoma (Madura foot); Madurella mycetomatis ✓
• B Sporotrichosis; Sporothrix schenckii
• C Chromoblastomycosis; Fonsecaea pedrosoi
• D Actinomycetoma; Nocardia brasiliensis

Explanation

Eumycetoma (Madura foot) is a chronic subcutaneous infection characterised by the triad of tumefaction, sinuses, and granules. Black granules indicate melanised (dematiaceous) fungi; the most common cause in India is Madurella mycetomatis. White/yellow granules are seen in actinomycetoma caused by Nocardia or Actinomadura. Chromoblastomycosis presents with verrucous plaques and shows sclerotic bodies (Medlar/copper penny bodies) histologically, not sinuses with granules. Diagnosis involves microscopy of granule crush preparation, culture, and histopathology. Treatment: voriconazole or itraconazole; surgical excision.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.