<prompt> A farmer present with multiple discharging sinuses in the leg not responding to antibiotics. Most likely diagnosis is:MadurellaActinomycetomaNocardiaSporothrix  <response>: Ans. a Madurella Actinomycetoma, usually responds to antibiotics. Treatment of Mycetonra Actinomycetoma Eumycetoma Prolonged combination chemotherapy, e.g. with streptomycin and either dapsone or cotrimoxazole, cotrimoxazole amikacin Rarely responds to chemotherapy, some cases caused by Madurella mycetomatic respond to ketoconazole itraconazole, posaconazole 