Tongue actinomycetoma due to Actinomadura madurae: a rare clinical presentation.

A 60-year-old male farmer presented with tongue swelling of 1-month duration. Local oral clinical examinations showed a painless firm mass in the anterolateral aspect of the anterior third of the tongue. Fine needle aspiration for cytology confirmed the diagnosis of tongue actinomycetoma due to Actinomadura madurae. The patient underwent wide local excision under general anesthesia and had an uneventful postoperative recovery. He was started on amikacin sulfate 15 mg/kg daily and cotrimoxazole 15 mg/kg twice per day for 6 months. The lesion healed completely, with no evidence of recurrence at 6-month follow-up. The route of infection in this patient is unclear; however, direct traumatic inoculation is the most likely route. To the authors' knowledge, this is the first report of tongue mycetoma in the medical literature.