Madura leg due to Exophiala jeanselmei successfully treated with surgery and itraconazole therapy.

Exophiala jeanselmei, also known as Phialophora jeanselmei, is a dematiaceous fungus widely distributed in nature. The organism can cause cutaneous, subcutaneous or systemic infections. An uncommon clinical presentation is eumycetoma, i.e., a subcutaneous infection associated with draining sinuses releasing clumps or granules of the fungus. We describe a case of a long standing mycetoma with several draining sinuses involving the left lower leg of a 47-year-old Saudi Arab male. The disease required extensive surgical excision coupled with intense antifungal chemotherapy to achieve cure.