Discussion
A patient with sulfur granules discharging from sinus, suggestive of infection with:
Answer: C
Correct answer: Mycetoma
Granules discharged through chronic sinuses are the hallmark of mycetoma, whether caused by a filamentous bacterium (actinomycetoma) or a true fungus (eumycetoma), and the granules are colonies of the organism growing within the pus. Actinomycosis produces the same picture at cervicofacial, thoracic and abdominal sites. Staphylococcal sinuses and chancroid discharge pus without granules, and sporotrichosis produces a chain of nodules along the lymphatics rather than granule-bearing sinuses.
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