An Unusual Case of Mixed Mycetoma by Actinomycete and Aspergillus Species

Abstract

Mycetoma is a chronic granulomatous infection of skin and subcutaneous tissues. It is a neglected disease worldwide with severe physical and psychological consequences as many cases end up with amputations. Proper diagnosis with tissue culture is the cornerstone of management. Mycetoma is caused either by fungi or actinomycetes, but mixed infection with both is a rarity. Here, I am reporting a case of mixed mycetoma caused by actinomycetes and fungi both, and share my experience of managing this difficult and unique case.

Keywords

• Mycetoma, Aspergillus fumigatus, Actinomadura madurae, Voriconazole, Mixed mycetoma, Itraconazole