MYCETOMA OF THE FOOT: A RARE CASE OF MADURAMYCOSIS IN A SUDANESE MALE LIVING IN SAUDI ARABIA

Mycetoma, a rare tropical disease, manifests as chronic subcutaneous granulomatous lesions predominantly found in the mycetoma belt, encompassing Sudan, Mexico, and India. This study offers a comprehensive discussion and literature review, delving into the historical evolution of mycetoma since its initial description as Madura foot in 1832. Clinical presentation typically involves painless subcutaneous masses, sinus tracts, and discharges, with the foot being the primary site of affliction. In the context of this broader discussion, we present the case of a 52-year-old Sudanese male residing in Saudi Arabia, who presented with a chronic, painful swelling in the right big toe. The subsequent diagnosis revealed Maduramycosis, providing a nuanced perspective within the clinical landscape. Diagnostic methodologies rely on clinical features, imaging, and cultures to identify causative microorganisms. Actinomycetoma, induced by gram-positive filamentous actinomycetes, demonstrates responsiveness to antibiotics like trimethoprim-sulfamethoxazole or high-dose penicillin G. Conversely, eumycetoma, associated with Mudrellamycetomatis, exhibits poor responses to antifungals, necessitating surgical interventions ranging from excision to amputation. This study underscores the dynamic epidemiology of mycetoma, with emerging cases noted outside traditional endemic regions. By unraveling the clinical enigma surrounding mycetoma, this research contributes to an enhanced understanding of this complex disease, paving the way for improved diagnostic and therapeutic modalities. Ongoing research remains pivotal to addressing the challenges posed by mycetoma and advancing global efforts to manage and prevent its impact on affected populations.