Abstract

The Hidden Fungus: A Case of Mycetoma Unveiled in a Young Adult’s Great Toe

Dhaniwala Nareshkumar S.1, Dhaniwala Mukund N.2, Dhaniwala Aditi M.3, Lohiya Ashutosh A.4

Keywords: Mycetoma, Eumycetoma, Actinomycetoma, hyphae, granules, histopathological examination

DOI: 10.63475/yjm.v5i1.0335

DOI URL: https://doi.org/10.63475/yjm.v5i1.0335

Publish Date: 17-04-2026

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Author Affiliation:

1 Professor, Department of Orthopaedics, MS Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi Meghe, Wardha, India
2 Consultant, Dhaniwala Orthopaedics and Dental Clinic, Nanded, India
3 Consultant, Dhaniwala Orthopaedics and Dental Clinic, Nanded, India
4 Senior Resident, Department of Orthopaedics, MS Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi Meghe, Wardha, India

Abstract

Mycetoma is a chronic granulomatous infection affecting subcutaneous tissues and bones, caused by either fungi or bacteria. Its varied causes and clinical manifestations often make diagnosis and treatment challenging. Eumycetoma, specifically, is a deep fungal infection of the skin and underlying tissue caused by filamentous fungi. We report a case of Eumycetoma in a healthy, immunocompetent 22-year-old male who presented with swelling and limited movement in his right big toe. On examination, a non-tender 3 cm × 2 cm × 1 cm swelling was observed on the dorsal side of the toe, leading the treating clinician to initially suspect tenosynovitis. An excisional biopsy was performed under spinal anesthesia, revealing multiple pockets within the subcutaneous tissue containing black granules. Further microbiological and histopathological analysis confirmed Eumycetoma. Treatment was started with itraconazole 200 mg twice daily for 6 months. At a 15-month follow-up, the patient remained symptom-free, with normal walking ability and no issues wearing regular shoes. There was no sign of recurrence or any neurovascular complications.