Fusarium as a Cause of Mycetoma: A Case Report and Review of the Literature

Abstract

Mycetoma is a chronic, slow progressive granulomatous infection of skin and subcutaneous tissue; is classified into Eumycetoma (caused by fungi) and Actinomycetoma (caused by Actinomycetes). Fusarium, is a known cause of mycetoma. This case report describes the isolation and identification of Fusarium sp. from a lesion on the right foot of a female patient. This case report is about a 23-year-old female with complaints of gradual enlarging nodular swelling with multiple discharging sinuses along with granules on the right foot, on and off for last seven years. The granules obtained from the lesions are the best specimen for culture as they contain microcolonies of causative agents and it’s a hallmark of mycetoma. Granules were collected aseptically, crushed and examined microscopically on 20% KOH preparation. Plenty of thin hyaline, septate hyphae were seen. Granules were washed with sterile saline and inoculated on Sabouraud’s Dextrose Agar (SDA) and potato dextrose agar and incubated aerobically at 25°C and 37°C in two sets of each. Colonies grew at inoculated site, pinkish in the centre and whitish in the periphery. The isolate was identified as Fusarium sp. on the basis of morphology. The patient was started on Itraconazole 200 mg and is currently on the same treatment, improving and under follow-up. Mycetoma is a rare disease caused by both fungal and bacterial microorganisms. Definitive diagnosis should be made on the basis of culture or histopathological examination. Once the diagnosis is made, use of appropriate anti-fungal therapy with or without surgical interventions can result in complete cure without recurrence.