An approach to histology-based diagnosis and treatment of Madura foot

Abstract

Madura foot is a deep mycosis commonly seen in tropical and subtropical countries such as India. Its incidence is likely to rise in temperate regions as well, due to the increase in worldwide travel. The cases presented here are all agricultural workers from a rural part of northern India who had induration, fibrosis and minimal discharge from sinuses over the foot. Although culture remains the gold standard diagnostic test, this case report highlights the importance of histopathology in the early diagnosis and differentiation of common causative agents in Madura foot as repeated cultures are sometimes negative. Thus for mycetomas in which causative infectious agents cannot be isolated, histology may prove beneficial by avoiding inadvertent use of combined antifungal and antimicrobial agents so that a correct therapeutic modality can be decided, prognostic outcome be explained to the patient, and a preventable cause of deformity and disability can be identified and treated at an early stage.

Eumycetoma on histopathology presenting at unusual site: A rare entity.

“…Eumycotic colonies are frequently surrounded by fibrotic tissue [7,12]. A Gram stain is of considerable value in distinguishing between actinomycetoma and eumycetoma.…”

Pedal Mycetoma Mimicking Plantar Fibroma

“…Fungal stains can also be done through microscopy of any visible discharge. Cytology, Histology [11], Enzyme linked immunosorbent assay (ELISA), Immunohistochemistry, and DNA sequencing have also been successfully used [5].…”

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“…Fungal stains can also be done through microscopy of any visible discharge. Cytology, histology 11 , enzyme-linked immunosorbent assay, immunohistochemistry and DNA sequencing have also been successfully used 5 . The treatment of choice is surgical excision with wide margins; antifungal or antibiotic treatment following surgical excision is debatable as the results are variable 3 .…”