Protracted mandibular swelling with Trismus: A rare case of chronic osteomyelitis secondary to eumycetoma

Eumycetoma in the maxillofacial region is a rare entity and long-term disease-causing osteomyelitis may possess a diagnostic challenge. We present a case of a 27-year female with painless swelling on the right cheek and right lower third of the face for 10 years. Orthopantomography (OPG) showed an extensive ill-defined radiopaque lesion (ground glass appearance). Histopathological examination revealed chronic granulomatous osteomyelitis with focal suppuration and reddish-brown grains of organisms, morphologically resembling mycetoma. Given consistent negativity for Gram's stain and positive GMS and PAS stain, diagnosis of Eumycetoma was favored over Actinomycetoma. To the best of our knowledge, this was the first case of extensive chronic granulomatous osteomyelitis caused by eumycetoma species.