system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A patient presented with a swelling in his right foot with multiple discharging sinuses that contained brown granules. The lesion did not respond to antibiotic medications. Which of the following is the causative agent?
assistant
The correct answer is  The history of multiple discharging sinuses that contained brown granules and the non-responsiveness to the antibiotics are suggestive of Eumycetoma. The causative agent of this is Madurella mycetomatis. Actinomadura and Nocardia cause actinomycetoma which would respond to antibiotics. Mycetoma is of two types: Eumycetoma Actinomycetoma Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition