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CASE REPORT
Chronic Madura foot: mycetoma and/or Actinomyces spp or actinomycosis
  1. Abdulaziz Al Gannass
  1. Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
  1. Correspondence to Dr Abdulaziz Al Gannass, royaldoctor{at}hotmail.com

Summary

A 58-year-old agricultural worker from a remote Western province farming community in Saudi Arabia presented with a 2-year history of right plantar foot soft tissue mass. According to the patient, the swelling had gradually increased in size over a few years, but it was painless and thus had not restricted him from continuing to farm until the lesion started to affect mobility. An MRI, microbiology and histopathology reported a rare infectious agent—Actinomyces spp, otherwise referred to as Madura foot. Three-dimensional CT aided in a preoperative surgical plan which included mass excision/debulking for this challenging lesion. Full eradication was not possible, and the patient required prolonged anti-infective therapy (>6 months) along with close surveillance to map resolution of infective symptoms.

  • endocrinology
  • diabetes
  • infectious disease
  • tropical medicine (infectious disease)
  • surgery

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Footnotes

  • Contributors The submitted case report has been undertaken solely by AAG. AAG was the consulting physician, requested all diagnostic tests and performed the surgery.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.