A 50 year old man presents to the clinic with multiple abcesses and discharging sinus present on his left foot. X-ray of the foot shows destructive changes in the underlying bone. Which of the following is the most likely causative organism?: (A) Nocardia, (B) Sporothrix schenkii, (C) Histoplasmosis, (D) Cryptospordiosis
Answer is A. Patient in this question is most likely suffering from Actinomycotic mycetoma caused by Nocardia and Actinomadura species. Disease begins as a papule or a nodule and slowly progress into multiple abcesses and sinus tracts ramifying deep into the tissue. Trimethoprim sulfamethoxazole or dapsone are effective in the treatment.