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Madura foot; mycetoma pedis
Etiology:
- Actinomyces (see mycetoma)
- true fungi
Epidemiology:
- Actinomyces account for most cases in patients from Mexico
Clinical manifestations:
- chronic edema
- subcutaneous nodules of the foot
- painful
- sinus tracts with periodic draining
- both plantar & dorsal surfaces of foot
Laboratory:
- skin biopsy
- whitish-yellow granules
- non-acid-fast filamentous bacteria
Radiology:
- CT or MRI to r/o osteomyelitis
Complications:
- difficulty fitting shoes
- difficulty ambulating
Management:
- long-term doxycycline for Actinomyces
- prognosis: after 8 months, patient in case report has near normal appearing foot [1]
General
mycetoma (fungus ball, Madera foot)
References
- Pickert AJ and Nguyen X
Madura Foot
N Engl J Med 2012; 366:e2January 5, 2012
http://www.nejm.org/doi/full/10.1056/NEJMicm1111051