Madura foot: a rare case of eumycetoma and proposed classification and treatment guidelines

• Main Authors: Kow, Ren Yi, Goh, Kian Liang, Sabbir, Hussain A, Hamdan, Asmah Hanim, Low, Chooi Leng
• Format: Article
• Language: English; English
• Published: International Islamic University Malaysia 2022
• Subjects: RB Pathology; RD Surgery; RD701 Orthopedics
• Online Access: http://irep.iium.edu.my/95983/7/95983_Madura%20foot%20a%20rare%20case%20of%20eumycetoma.pdf; http://irep.iium.edu.my/95983/13/95983_Madura%20Foot_%20A%20Rare%20Case%20of%20Eumycetoma_Scopus.pdf; http://irep.iium.edu.my/95983/; https://journals.iium.edu.my/kom/index.php/imjm/article/view/1473/1281

Madura foot or mycetoma pedis is a chronic granulomatous disease of the foot caused by fungus or gram-positive aerobic bacteria. It is commonly encountered in tropical and subtropical countries but is rare in Malaysia. We report a 40-year-old Rohingya refugee, a resident in Malaysia for the past 11 years, who presented with a long-standing left foot mass that was proven to be a eumycetoma. Wide local excision of the mass and full-thickness skin graft were done, followed by a 6-month course of postoperative itraconazole. He subsequently recovered well without any sequela. A high index of suspicion should be raised in a patient presenting with a chronic mass and discharging sinus in order to diagnose and treat mycetoma as early initiation of therapy leads to better outcomes. Based on literature review, we propose a new classification of eumycetoma and its treatment guidelines.