Eumycetomas are chronic suppurative granulomas caused by fungi characterised by invasive tumefactive lesions, sinuses and discharging grains. Herein, we describe a case of pedal eumycetoma due to Fusarium solani sensu stricto in a person with diabetes mellitus. A 45-year-old gentleman presented with an insidious onset swelling over his right foot with nodules and discharging grains. He had received itraconazole and anti-tuberculous therapy elsewhere, without response. Re-evaluation included a biopsy which confirmed eumycetoma and newly diagnosed diabetes. Surgical excision followed by histopathological, microbiological and multigene sequencing analyses [translation elongation factor, calmodulin and internal transcribed spacer region of rDNA] of the mould on culture were performed. Histopathology revealed septate fungal hyphae amidst a dense inflammatory infiltrate (Splendore–Hoeppli) reaction. Oral voriconazole was started and good glycemic control attained. Tissue growth sequences showed > 99% similarity with Fusarium solani sensu stricto. Antifungal susceptibility testing showed lowest MIC to voriconazole (0.5 mg/L). The patient showed excellent response to combined therapeutic modality with a near-complete resolution in size of lesion and obliteration of sinuses following 4 months of therapy and is planned for prolonged voriconazole therapy till complete radiological resolution. Diabetes predisposes to fungal infections of foot but eumycetomas are uncommon. Combined surgery and antifungals can improve morbidity and avoid amputations.

真菌性肉芽肿是由真菌引起的慢性化脓性肉芽肿，以侵袭性肿瘤、鼻窦和排出颗粒为特征。在此，我们描述了由茄病镰刀菌引起的足部真菌瘤的案例糖尿病患者的严格意义上。一位 45 岁的绅士因右脚隐匿性肿胀、结节和排出颗粒就诊。他曾在别处接受过伊曲康唑和抗结核治疗，但无反应。重新评估包括活检，证实了真菌瘤和新诊断的糖尿病。对培养的霉菌进行手术切除，然后进行组织病理学、微生物学和多基因测序分析 [翻译延伸因子、钙调蛋白和 rDNA 的内部转录间隔区]。组织病理学显示在密集的炎症浸润（Splendore-Hoeppli）反应中存在有隔真菌菌丝。开始口服伏立康唑并获得良好的血糖控制。组织生长序列与Fusarium solani显示 > 99% 的相似性严格意义上。抗真菌药敏试验显示对伏立康唑的最低 MIC (0.5 mg/L)。患者对联合治疗方式表现出良好的反应，在治疗 4 个月后病变大小和鼻窦几乎完全消退，并计划延长伏立康唑治疗直至放射学完全消退。糖尿病易患足部真菌感染，但真菌瘤并不常见。联合手术和抗真菌药物可以提高发病率并避免截肢。