Madura Foot - Early Presentation

Introduction and Significance: Mycetoma / Madura foot, is a chronic , progressive granulomatous condition affecting the skin , subcutaneous tissue and bones. It is primarily caused by fungi or anaerobic filamentous bacteria and is prevalent in tropical and subtropical regions, particularly among males aged 20-50 years who are exposed to outdoor environments, especially farmers.  Case Presentation: We report the case of a 50 year old male patient with history of fieldwork with early presentation as swelling over right foot medial aspect with symptoms of minimal discharge from sinuses, fibrosis and induration.  Clinical Discussion: Madura foot is one of the neglected tropical disease characterized by localized soft tissue injury with discharge grains containing infectious material. Fungal induced cases are termed eumycetomas, while bacterial forms caused by actinomycetes are referred to as actinomycetomas. Diagnosis typically relies on clinical evaluation, radiolographic findings and microscopic/histopathological examination.surgical excision of lesion combined with medical therapy is often the most effective treatment.  Conclusion: Madura foot is long-standing infection commonly found in tropical and subtropical regions such as india .due to its varied presentation,diagnosis of madura foot can be challenging, however ,culture remains the gold standard diagnostic test , histopathology is crucial for the early diagnosis and definitive treatment of these cases . actinomycetoma can be cured with surgical debridement and appropriate antibiotic therapy while eumycetoma is only partially responsive to antifungal agents has high rate of recurrence and may require amputation.