We describe a case of mycetoma caused by with simultaneous involvement of the spine, abdominal wall and retroperitoneal space in a man who had suffered from ‘Madura foot’ 10 years earlier. The characteristics of this case were analysed and contextualized among those of other cases of mycetoma caused by other micro-organisms found through a review of the international literature. The rarity of the disease in industrialized countries and its possible atypical presentations may hinder a prompt diagnosis. Culture techniques that allow detection of slow-growing fungi and actinomycetes should be routinely used when dealing with tissue samples from patients from tropical and subtropical regions with chronic granulomatous infections.


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vol. , part 5, pp. 673 - 676

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Ultrasonographic view of two inhomogeneous, subcutaneous abscesses (*); white arrows show numerous sharp, bright, hyper-reflective echoes, consistent with the red grains (sized 0.2–0.4 mm).

CT image showing spinal canal obliteration (black arrows) and multiple subcutaneous, retroperitoneal and paravertebral abscesses (arrowheads).

Magnetic resonance image of the spine showing the affected 11th dorsal vertebra (white arrow) with a perivertebral inflammatory response (black arrow).

Magnetic resonance image of the spine showing 2 abscesses (white arrows) with inflammatory reaction (*).

Standard radiography of the right leg, showing bone loss at the tibial metaphysis (long black arrow). A lytic lesion is detectable at the proximal fibula (long black arrow) with a honeycomb aspect, associated with a periosteal reaction (short arrows) deforming the bone profile.

Giemsa staining of the exudate smear showing two grains appearing as broken dishes (original magnification ×1000).

Subculture of on Löwenstein-Jensen medium.

Gram staining showing branched Gram-positive filaments.

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