Background:

Mycetoma is a chronic granulomatous infection caused by fungi or filamentous bacteria, typically presenting with tumefaction, draining sinuses, and granule formation. Other deep fungal infections may mimic its clinical presentation. Candida parapsilosis is an opportunistic yeast that usually causes superficial infections, and primary cutaneous candidiasis is rare, particularly in immunocompetent individuals.

Case Presentation:

We report a 47-year-old Filipino female with a four-year history of a verrucous exophytic mass with black grains and reddish globules on the plantar foot initially suspected as eumycetoma. Histopathology revealed pseudoepitheliomatous hyperplasia with granulomatous inflammation, while fungal culture and automated identification confirmed Candida parapsilosis. Antifungal susceptibility testing demonstrated resistance to fluconazole and voriconazole but susceptibility to echinocandins and amphotericin B. Due to limited resources, patient was treated with itraconazole 200 mg daily for 6 months, resulting in symptomatic improvement

Conclusion:

This case highlights the importance of considering Candida parapsilosis infection in chronic verrucous foot lesions resembling mycetoma. Culture and susceptibility testing remain essential to ensure accurate diagnosis and guide appropriate antifungal management.