Mycetoma of the hand

Mycetoma or maduromycosis is a rare chronic granulomatous disease caused by a fungus infection. We report a rare case of mycetoma in the hand; to our knowledge this is the first report in the United States of mycetoma caused by Nocardia asteroides. The patient had had 2 years of chronic drainage and edema of the left hand after a penetrating injury sustained in the shipyards. After surgical debridement he was treated with co-triamazole, 1 tablet orally four times a day for 6 months. The chronic drainage has ceased but most of his wrist and hand joint movements are restricted.