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Mycetoma is a chronic subcutaneous fungal infection characterized by tumefaction, draining sinuses, and grains. It is most common in the tropics but occasionally occurs in the United States. We report a case of a mycetoma affecting the foot of a 38-year-old mentally retarded man from northern New England. The causal organism was identified as Pseudallescheria boydii, the most common cause of mycetoma in the United States. The patient showed a partial response to 8 months of ketoconazole therapy.
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