EUMYCETOMA OSTEOMYELITIS IN ABORIGINAL RENAL TRANSPLANT PATIENT- CASE REPORT

F YUSUF , P NAIDU , M SUNDARAM , E MEUMANN

1Royal Darwin Hospital, Tiwi, Australia

Eumycetoma is a chronic, insidious subcutaneous fungal infection typified by painless tumour formation with sinus and grainy discharge. It is endemic in developing countries with tropical climates especially in farmers or labourers who work without protective footwear. It is most commonly seen on feet and lower limbs after inoculation via trauma to these areas, hence the colloquial name “Madura foot” where the condition was first described in India in the 1800s. In developed countries, it is seen mostly in immunocompromised patients. It often presents as a localised unilateral lesion, though there are cases in literature of locally invasive disease as well as disseminated disease. Typical management includes surgical resection in conjunction with prolonged anti-fungal therapy.

Phaeoacremonium is a fungal species that has been identified as an opportunistic eumycetoma pathogen. It is a soil saprophyte and is usually seen either in symbiotic relationships with or in diseases involving grape vines or woody vegetation. There have been 17 case reports in literature world-wide documenting human infection with various phaeoacremonium species. To our knowledge, this is the first to be documented in Australia.

We describe a case report of 62 year old Aboriginal man who developed eumycetoma (Phaeoacremonium fuscum species) related osteomyelitis one year post renal transplant and to our knowledge there has been no previous reported cases of Eumycetoma Osteomyelitis in Aboriginal renal transplant patients and it serves as a timely reminder to suspect this rare but treatable infection and prevent lifelong functional disability.


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