Background: Eumycetoma is a chronic subcutaneous infection endemic to tropical and subtropical countries, but there is limited experience in managing this condition outside of these regions.
Methods: This study reviews the clinical features, radiology, mycology and treatment of a patient with eumycetoma managed by St Vincent’s Health, Melbourne.
Results: A 40-year-old Somali-born male presented to our institution with the third recurrence of a subcutaneous mass on the plantar aspect of his 4th metatarsal. The lesion was slow growing, painless and intermittently discharged “small black seeds”. The lesion was removed surgically following three months of empiric anti-fungal therapy. Prolonged culture was required to grow the causative organism which was able to be identified as Madurella fahalii via molecular techniques. The patient’s therapy was altered to voriconazole 200mg twice daily, and he currently remains on treatment without any evidence of disease recurrence 6 months post-surgery.
Conclusion: For this case of recurrent eumycetoma, combined medical and surgical therapy has resulted in a successful therapeutic outcome. Further research is required to establish the optimal choice of antifungal agent and duration of therapy.