A Longstanding Case of Black Grain Mycetoma in a Somalian Male Patient: A Case Report.

Mycetoma is a chronic granulomatous infection predominantly affecting young individuals, characterized by painless swelling and often misdiagnosed due to its resemblance to other conditions. This case report presents the first documented instance of eumycetoma located in the buttock of a 44-year-old male patient from Somalia, a region with limited literature on this disease. The patient exhibited a 10-year history of indurated swelling, which progressed to the discharge of dark granules, leading to the diagnosis of black grain eumycetoma. Comprehensive diagnostic methods, including imaging and histopathological analysis, were used, confirming the fungal etiology. Surgical excision followed, alongside antifungal therapy, resulting in significant improvement. This case emphasizes the necessity for increased awareness and consideration of mycetoma in clinical practice, especially in atypical presentations and underreported geographical areas.