Madura's foot in native of the Philippines immigrant in northern Italy

Clinical case about a man, emigrated from Philippines. The patient presented a single cutaneous lesion on a foot that was thick, swollen and blackish. There were no fistulas. He remenbers a traumatic implantation of wood splinters on the sole foot 10 years ago. Radiography, Magnetic Resonance, tomographic investigation were performed. The exceptional occurrence of the mycetoma in our countries and absence of clear infectious picture were the reason for an initial clinical misinterpretation as a benign neoplasm of soft tissues.We performed surgical removal of neoplasm, with histological examination.Histopathologic exam revealed an unexpected mass of fungal hyphae; diagnosis of Madura’s foot was confirmed. We started pharmacological therapy with “itracozanole”.Our case offers opportunity to stress need for clinical suspicion of fungal infection, considering increase of immigration by the countries with endemic mycetoma, and we must prepare to observe and treat many pathologies now unknown in our practice.