PMC7470292_01
Chest x-ray from the patient, showing nodular lesions across both lungs.
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F1
A 57-year-old man with no history of human immunodeficiency virus (HIV) infection, immunodeficiency or consumption of immunosuppressive drugs was admitted to hospital in Isfahan, with symptoms including a 4-month history of a cutaneous wound on his left foot acquired during agriculture, persistent fever (39  C), weakness, persistent non-productive cough and chest pain; a chest x-ray was taken and evaluation of radiological pictures showed nodular lesions across both lungs (Fig. 1); Purified protein derivative (PPD) test was negative and a erythrocyte sedimentation rate (ESR) of 57 mm h-1 was present.
Cutaneous wound on the left foot of the patient.
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F2
However, the patient was not treated after 2 weeks and his cutaneous wound had not improved and developed into a productive large lesion, expelling yellow-wan pus similar to mycetoma (Fig. 2).