Histopathological Diagnosis of Eumycetoma With Paraspinal Sinuses: A Rare Case Report

Mycetoma, well known as “Madura foot,” is a long-standing granulomatous infection of the skin and subcutaneous tissue. Causative organisms are filamentous fungi (eumycetes) and bacteria (actinomycetes). It characteristically presents with firm woody swelling, discharging sinuses with grains (containing the causative organism). Diagnosis in suspected cases can be made by microbiological evaluation, histopathological, cytological and radio imaging techniques. To differentiate between eumycetoma and actinomycetes histopathology is an accurate diagnostic modality as seen in the present case. We report a case of 42 years male who presented with swelling on his back with discharging sinus. Histopathological specimen containing multiple, irregular, greyish, whitish tissue pieces with skin attached all together measuring around 12×9×4 cm from the paraspinal region. The section shows histopathological features suggestive of eumycetoma. Periodic acid -Schiff stain showed the presence of septate, branching fungal hyphae and black granules. Eumycetoma can be accurately diagnosed by histopathological evaluation using a special stain. It is confirmatory and provides a guide for treatment plans with a high index of suspicion.