PMC3140148_01
Perineal lesions
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F0001
A 36-year-old man, farmer by occupation, presented with 8-year history of nonhealing lesions on the thigh and genitals [Figure 1].
Melanotic granules expressed out from the lesions
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F0002
On pressing, the dark melanotic granules were expressed out [Figure 2].
H and E histopathology with organized aggregates of filaments
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F0003
There were neutrophilic abcesses with organized aggregates of filaments [Figure 3] and 1% AFB revealed no acid fast filaments.
Madurella mycetomatis in Sabouraud's dextrose agar (two cultured specimens of patient) with leathery colony and brown pigment production compared with control
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F0004
On culture of the granules (washed with sterile saline and inoculated on to Sabouraud's dextrose agar) revealed the organism to be Madurella mycetomatis [Figure 4].