This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Microbiology
A farmer present with multiple discharging sinuses in the leg not responding to antibiotics. Most likely diagnosis is: 
Select and explain. 
A. Madurella, B. Actinomycetoma, C. Nocardia, D. Sporothrix
A: Madurella
Answer: A: Madurella 
Explanation: Ans. (a) Madurella Actinomycetoma, usually responds to antibiotics. Treatment of Mycetonra Actinomycetoma Eumycetoma Prolonged combination chemotherapy, e.g. with streptomycin and either dapsone or cotrimoxazole, cotrimoxazole + amikacin Rarely responds to chemotherapy, some cases caused by Madurella mycetomatic respond to ketoconazole itraconazole, posaconazole