title: Madura leg due to Exophiala jeanselmei successfully treated with surgery and itraconazole therapy.
abstract: Exophiala jeanselmei, also known as Phialophora jeanselmei, is a dematiaceous fungus widely distributed in nature. The organism can cause cutaneous, subcutaneous or systemic infections. An uncommon clinical presentation is eumycetoma, i.e., a subcutaneous infection associated with draining sinuses releasing clumps or granules of the fungus. We describe a case of a long standing mycetoma with several draining sinuses involving the left lower leg of a 47-year-old Saudi Arab male. The disease required extensive surgical excision coupled with intense antifungal chemotherapy to achieve cure.
authors.affiliation: Internal Medicine Services Division, Dhahran Health Center, Saudi Aramco Medical Services Organization, Saudi Aramco, Dhahran, Saudi Arabia. jaffar.tawfiq@aramco.com
authors.forename: Jaffar A
authors.initials: JA
authors.lastname: Al-Tawfiq
authors.forename: Samir S
authors.initials: SS
authors.lastname: Amr
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D005093:Exophiala / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D017964:Itraconazole; D007866:Leg / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008271:Mycetoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D012529:Saudi Arabia
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole