Mycetoma in a non-endemic area: a diagnostic challenge

BACKGROUND: Mycetoma is a chronic granulomatous infectious disease caused by filamentous bacteria or by fungi. The disease is endemic in certain tropical and subtropical areas of the world but can be found elsewhere posing sometimes a diagnostic challenge for clinicians. CASE PRESENTATION: A 65-year- old man presented with a right foot swelling evolving for 25 years. During that time, several diagnosis and treatments have been made without any improvement. The disease spread to bones, and misdiagnosed as Kaposi’s sarcoma. Transtibial amputation has been performed, and the histopathological examination revealed finally the diagnosis of eumycotic mycetoma. The patient recovered well after surgery and orthopedic prosthesis was prescribed for him. CONCLUSION: Mycetoma in non endemic areas is usually misdiagnosed and mismanaged leading to unnecessary and inappropriate surgery. Health practitioners should be aware of that fact in order to provide an accurate management.