Mycetoma caused by Nocardia madurae

Area of Science:

• Medical Mycology
• Infectious Diseases
• Clinical Case Reports

Background:

• Actinomycotic mycetoma is a chronic fungal infection.
• Nocardia madurae is a rare causative agent of mycetoma.
• This case represents the first report of Nocardia madurae-induced mycetoma in Canada.

Observation:

• A case of actinomycotic mycetoma was diagnosed in a patient from Jamaica residing in Ontario, Canada.
• The causative agent was identified as Nocardia madurae.
• The patient presented with subcutaneous nodules.

Findings:

• This represents the first reported case of Nocardia madurae-induced mycetoma in Canada.
• Standard oral therapy with trimethoprim-sulfamethoxazole was partially effective.
• Periodic local excision of new nodules was necessary for clinical improvement.

Implications:

• This case highlights the importance of considering rare fungal and bacterial infections in immunocompetent individuals presenting with subcutaneous nodules.
• Modified laboratory procedures may be crucial for accurate identification of challenging pathogenic actinomycetes.
• Increased awareness and diagnostic capabilities for actinomycotic mycetoma are needed in non-endemic regions.