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What is A farmer presents with multiple dicharging sinuses in the leg not responding to antibiotics. Most likely diagnosis is - and explain in detail?
Ans. is 'a' i.e., Madurella . Multiple discharging sinuses not responding to antibiotics suggest the diagnosis of mycetoma. . Actinomycetoma may respond to antibiotic therapy. eg. combination of streptomycin and dapsone or combination of streptomycin and trimethoprim sulfamethoxazole. . Actinomycetoma is caused by Actinomadura, Nocardia and streptomyces. . Eumycetoma rarely respond to antibiotics, some cases caused by madurella mycetoma have appeared to respond to ketoconazole or itraconazole.