Actinomycetoma
Actinomycetoma due to nocardiosis is a slowly progressive, destructive infection of the cutaneous and subcutaneous tissues, fascia, and, as seen here, bone. Actinomycetoma starts as a nodule, suppurates, spreads along fascial plains, and drains through chronic fistulas.
Image courtesy of Dr. Libero Ajello via the Public Health Image Library of the Centers for Disease Control and Prevention.
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