DOI: 10.21276/sasjs.2019.5.4.6

Pages: 221-224

Introduction: Mycetomas are chronic skin and subcutaneous progressive disease caused by bacterial agents (actinomycetoma in 60% of cases), or fungal (eumycetoma in 40% of cases). Observation: This is a 47-year-old patient from a rural background, who has a notion of walking barefoot and pre-eminent trauma with a piece of wood. She has presented, for 20 years, a polyfistulisedmultinodular cupboard of the back of the right foot measuring 10cmx 6cm, firm and painless with white-yellowish grains at the pressure and absence of lymphadenopathy. A first cutaneous biopsy showed polymorphous diffuse granuloma appearance with no sign of malignancy. The bacteriological and mycological study of cutaneous fragments and grains was not contributive. X-ray of the foot did not reveal bone involvement. The patient underwent a large excisional biopsy of the polyfistulised cupboard. The histological study of the operative specimen showed an aspect in favor of actinomycosis. The patient underwent a skin graft and was treated with trimethoprim-sulfamethoxazole 800 mg / 160 mg: 2 cp / d because the patient is allergic to penicillin with a good clinical course.