# Orbital actinomadura madurae actinomycetoma: Case report and literature review

## TL;DR

A farmer from Sudan had a persistent eyelid mass misdiagnosed until it was correctly identified as a rare orbital mycetoma.

## Contribution

This case report highlights the importance of considering orbital mycetoma in differential diagnoses in endemic regions.

## Key findings

- The patient's mass was initially misdiagnosed as a lacrimal gland tumor.
- Orbital mycetoma caused by Actinomadura madurae was confirmed after excision.
- Early diagnosis is crucial for effective treatment in endemic areas.

## Abstract

The reported patient is a middle-aged farmer from West Sudan who presented with a painless mass in the right upper eyelid that progressively enlarged over time. His medical treatment journey was prolonged and difficult. The mass was initially misdiagnosed as lacrimal gland pleomorphic adenoma. The patient was later referred to a specialised center, where wide local excision confirmed the diagnosis of Actinomadura madurae actinomycetoma. Although orbital mycetoma is uncommon, it is a serious condition that should be considered in the differential diagnosis in endemic areas.

We report a middle-aged farmer from West Sudan who had an orbital mycetoma. He had a mass in his right upper eyelid that was getting bigger but not hurting. The patient had a long and difficult medical journey because they were first given the wrong diagnosis of a lacrimal gland pleomorphic adenoma. It wasn’t until a large local excision at a specialized center that the exact diagnosis of Actinomadura madurae actinomycetoma was made. Orbital mycetoma is a serious condition that should be thought about as a possible diagnosis, especially in places where it is common, to make sure that the right treatment is given at the right time.