A recent immigrant from Africa presents with tumorlike deformities of the subcutaneous tissue and multiple sinus tracts that drain pus containing granules.The fungus culture reveals a hyaline septate fungi.The most likely diagnosis would be

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A mycetoma is a chronic granulomatous infection that usually involves the lower extremities but may occur in any part of the body. The infection is characterized by swelling, purplish discoloration, tumorlike deformities of the subcutaneous tissue, and multiple sinus tracts that drain pus containing yellow, white, red, or black granules. The color of the granules is in part due to the type of infecting organism. The infection gradually progresses to involve the bone, muscle, or other contiguous tissue and ultimately requires amputation in most progressive cases. Rarely there is dissemination of the organism, but this is uncommon. Mycetoma is usually seen among persons who live in tropical and subtropical regions of the world, whose outdoor occupations and failure to wear protective clothing predispose them to trauma. Eumycotic (fungal) mycetoma is caused by a heterogeneous group of fungi having septate hyphae.

A Recent Immigrant from Africa Presents with Tumorlike Deformities of the Subcutaneous