Case report mycetoma foot: A reconstructive challenge

Introduction: Plastic and reconstructive surgery is instrumental in salvaging and saving limbs from getting amputated in many deeper plane infections and crush injuries, one such infective disease is Mycetoma foot. Mycetoma foot is a chronic granulomatousdisease caused either by fungi or bacteria. The disease is endemic in many states of India and is a slowly progressive but destructive nature which is managed late because of the dilemma of diagnosis and it needs both surgical and pharmacotherapy management to beat the disease. If not diagnosed at all, leads to amputation of the involved part. Case Report: Here we are presenting a case report of Mycetoma foot in a 40year old male, North India. Patient had the skin lesion over dorsum of right foot,which progressed over plantar with in18months and was continuously progressing in deeper planes and was diagnosed incorrectly. Patient was diagnosed with Mycetoma right foot because of strict clinical suspicion and proven with biopsy. Radical debridement was done followed by reconstruction with free Latissimus Dorsi muscle flap cover and targeted pharmacotherapy started. Conclusion: Mycetoma foot is a reconstructive challenge because of late diagnosis and involvement of deeper tissue like foot bones. Most of the patients are suggested amputation under such circumstances. Salvaging limb in this condition needs microvascular free tissue transfer with simultaneous long pharmacotherapy. Regular follow up is the rule for long post-operative period.