An atypical manifestation of mycetoma around knee joint – A case report

A chronic granulomatous disease called mycetoma affects subcutaneous tissue and in more advanced stages, destroys bone. Large, painless swellings that resemble tumours, nodules and draining sinuses and a discharge that contains grains are its distinguishing features. A 40-year-old man arrived at our outpatient clinic complaining of diffuse edema and pain surrounding his left knee joint that had been present for the previous two years, along with sinus and granular discharge. The patient claims to have had a thorn prick thirty years ago. One differential diagnosis for the current situation was septic arthritis. Mycetomas are usually classified using a classification called "staging-classification of mycetoma," and the current case was classified as Stage-C. Based on the "Staging classification of mycetoma," the patient's condition was identified as Stage-C mycetoma due to pain and generalized oedema around the left knee. The isolated organism was Madurella mycetomatis. A comprehensive curettage involving multiple stages, debridement and excision of damaged tissue from the anterior and posterior aspects of the knee joint using various techniques was carried out. Anti-fungal medication was added for six months prior to and six months following the procedure and the results at the 6-month mark indicated a favourable outcome.