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Fig 1.

Photo showing massive disease involving the lower posterior and anterior abdominal walls, with massive skin affection, multiple sinuses, and disarticulation of the right lower limb.

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Fig 2.

MRI showing an aggressive infiltrating lesion invading the pelvis and lumber region that extends from the posterior abdominal wall, with a sizable intrapelvic and intraabdominal extension infiltrating the lumber and sacral vertebrae and an intraspinal epidural extension displacing the abdominal organ to the left; in addition, there were many “dot-in sign” of mycetoma.

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Fig 3.

The macroscopic appearance of the purulent sputum with a small clump of mucoid substances and black grains.

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Fig 4.

CT scan showing extensive cystic lesions and massive destruction of the lumber vertebrae, sacrum, and left iliac bone associated with paravertebral soft tissue mass extending to the psoas muscles.

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Fig 5.

Chest CT scan showing a massive left pleural effusion with collapsed left lung.

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