Fig 1.
Clinical presentation (A) before surgery: soft tissue swelling of the left forefoot. (B) T1-weighted fat-saturated post contrast MRI reveals a large polycyclic intermetatarsal mass surrounded by a thick wall.
Fig 2.
(A) Macroscopic aspect of a paraffin block revealing multiple black granules in an oval zone of necrosis (arrow), surrounded by a wall of granulation tissue (asterisk). (B) Histological wholemount section with wall of fibrous tissue (asterisk) (Hematoxylin and eosin stain).
Fig 3.
High-power magnification. (A) Necrotizing inflammation with epithelioid-giant cells (arrow) (Hematoxylin and eosin stain). (B) Fungal hyphae (double arrow) (Grocott's Silver stain).
Fig 4.
(A) Clinical presentation after drainage of the subcutaneous abscess (arrow). (B) T2 fat-saturated MRI reveals diffuse inflammation of the soft tissue and a pathognomonic central hypointense dot (arrow) surrounded by hyperintensities reflecting the grain.
Fig 5.
Agar plate of the M. mycetomatis isolate producing a brownish diffusible pigment in the agar.
Fig 6.
Prevalence and number of reported cases of mycetoma.
(A) Average prevalence of mycetoma cases as calculated by the number of cases reported in a year in a certain country divided by the total population of that country of that same year as reported by www.indexmundi.com/facts/indicators/SP.POP.TOTL/compare. (B) The average number of mycetoma cases reported per year per country. Reprinted from van de Sande [4] under the terms of the Creative Commons Attribution License (http://dx.doi.org/10.1371/journal.pntd.0002550.g002).