Mycetoma (also known as maduromycosis or Madura foot) is a chronic fungal infection, usually of an extremity, that is characterized by induration and draining sinuses. This clinical entity is not commonly seen in the United States,1 and, even worldwide, only rarely is Acremonium falciforme (Cephalosporium falciforme) found to be the causative organism.1-3 We report herein the first case, to our knowledge, of mycetoma due to this organism occurring in a renal transplant patient.

Report of a Case  In 1975, a 60-year-old man had undergone a transplantation of a kidney, which had been donated from a living relative, because the patient had had chronic renal failure secondary to chronic glomerulonephritis. His condition was maintained on an immunosuppressive regimen of 100 mg/day of azathioprine and 30 mg/day of methylprednisolone. The patient was also a diabetic and required insulin therapy. He had worked as a blacksmith for the railroad, retiring prior