Painless foot swelling with a chronic purulent discharge

• Published in: The Western journal of medicine Vol. 174; no. 2; pp. 96 - 97
• Main Authors: Papaioannides, Dimitrios, Akritidis, Nikolaos K
• Format: Journal Article
• Language: English
• Published: United States Copyright 2001 BMJ Publishing Group 01.02.2001; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Adult; Care and treatment; Diagnosis, Differential; Foot Dermatoses - diagnosis; Foot Dermatoses - therapy; Fungi; Humans; Infections; Male; Mycetoma; Mycetoma - diagnosis; Mycetoma - therapy; Mycoses; Skin; Tropical diseases; United States
• ISSN: 0093-0415; 1476-2978
• DOI: 10.1136/ewjm.174.2.96

DIFFERENTIAL DIAGNOSIS The differential diagnosis of mycetoma includes chronic osteomyelitis resulting from bacteria, mycobacteria, or actinomycosis; other deep fungal infections, such as blastomycosis, coccidioidomycosis, or sporotrichosis; botryomycosis; leishmaniasis; yaws; syphilis; and chromoblastomycosis. 2 , 4 The diagnosis is determined on the basis of microscopic examination of pus and granules with potassium hydroxide preparation, Gram stain, and acid-fast stains of smears and by culture of the grains. 4 , 5 The shape and color of the grains, along with their appearance in tissue subjected to skin biopsy, may be helpful in identifying the causative agent. 2 , 4 TREATMENT Treatment of mycetoma is difficult, in part because the condition is usually in an advanced stage by the time the diagnosis is made.