Fungal infections: mycetoma: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Fungal infections: mycetoma

Sample item

A barefoot farmer has a painless swollen foot with multiple draining sinuses discharging black grains. Which statement is correct?

AIt is always bacterial and cured by penicillinBIt spreads rapidly through lymphatics to the liverCBlack grains suggest eumycetoma, which needs antifungal therapy with surgeryDGrains are absent in true mycetoma

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Black grains suggest eumycetoma, which needs antifungal therapy with surgery

Mycetoma is a chronic granulomatous infection with swelling, sinuses and grains. Eumycetoma (for example Madurella) gives black grains and is treated with itraconazole plus surgery, while actinomycetoma responds to co-trimoxazole with amikacin.

Option by option

A. It is always bacterial and cured by penicillin
Fungal mycetoma does not respond to penicillin.
B. It spreads rapidly through lymphatics to the liver
Mycetoma spreads locally to bone, not via lymphatics to liver.
C. Black grains suggest eumycetoma, which needs antifungal therapy with surgery (correct)
Correct. Black grains point to a fungal aetiology.
D. Grains are absent in true mycetoma
Grains are a defining feature of mycetoma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Black grains suggest eumycetoma, which needs antifungal therapy with surgery. Mycetoma is a chronic granulomatous infection with swelling, sinuses and grains.

Why is "It is always bacterial and cured by penicillin" not the answer?

Fungal mycetoma does not respond to penicillin.

Why is "It spreads rapidly through lymphatics to the liver" not the answer?

Mycetoma spreads locally to bone, not via lymphatics to liver.

Why is "Grains are absent in true mycetoma" not the answer?

Grains are a defining feature of mycetoma.

What concept does this question test?

It tests Fungal infections: mycetoma in Dermatology. Eumycetoma (for example Madurella) gives black grains and is treated with itraconazole plus surgery, while actinomycetoma responds to co-trimoxazole with amikacin.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Fungal infections: mycetoma?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.