Maduromycosis (Madura foot) in Kentucky

The first case of proven maduromycosis originating in the state of Kentucky, and the 21st case reported in the United States, is described. The disease, which involved the foot, was caused by Monosporium apiospermum. The importance of suspecting and culturing for fungal organisms in cases of chronic or recurrent infections of the extremities is stressed. The method of treatment was experimental; whether true cure was accomplished may not be known for years. Although many fungi, including Monosporium apiospermum, are relatively resistant to all forms of chemotherapy, some types of fungi readily respond to easily administered antibiotics. Specific fungal identification by trained mycologists is important in all cases of mycetoma.