Cytodiagnosis of primary actinomycotic mycetoma of the foot

Abstract

Sneha S Desale, Dhiraj B Nikumbh, S N Kanthikar, Akshay Surana

Mycetoma is chronic suppurative granulomatous disorder of subcutaneous tissue characterized by localized swelling with multiple discharging sinus tracts of granules that are micro colonies of the causative agent. Madura foot/mycetomas are the infection caused by true fungi (eumycetoma) in 40% or filamentous bacteria (actinomycetoma) in 60% of the cases. Painless subcutaneous mass, multiple sinuses and purulent or seropurulent discharge that may contain grains is characteristic of mycetoma. Mycetomas are usually diagnosed on histopathology. There are very limited data on role of fine-needle aspiration cytology (FNAC) in diagnosing these lesions. The distinction between eumycetoma and actinomycetoma in FNAC is as accurate as histopathology. Herein, we report a case of primary actinomycotic mycetoma of right foot in 65-year-old male patient. FNAC of soft tissue mass was advised, which revealed mixed inflammatory infiltrate with clumps of fibrillar organisms and occasional foreign body giant cells. Cytodiagnosis of actinomycetoma was rendered and Gram-stain was done later demonstrated Gram-positive thin branching filaments. Mycetoma can be accurately diagnosed by FNAC in outpatient department, which is simple, inexpensive, routine procedure for rapid diagnosis, and differentiation of etiology as the treatment differs.

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