Mycetoma is a subcutaneous infection caused by either fungi (eumycetoma) or actinomycetes (actinomycetoma). The focus of infection is the subcutaneous tissue, including subcutaneous fat. The hallmark of the infection is that the microorganisms involved form into clusters of filaments called grains and these are surrounded by a dense neutrophil response, forming an abscess. These abscesses subsequently discharge onto the skin surface via draining sinuses but may affect underlying bone, resulting in osteomyelitis. Infective organisms are implanted into the skin, usually following a thorn injury.1

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