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Subcutaneous nodules, some 20 years after a fall in Namibia, diagnosed in Belgium: imported pathology may take a long time before diagnosis
  1. L Ide1,
  2. J Knol2,
  3. L Op De Beeck2,
  4. I Surmont3
  1. 1
    Jan Palfijn Ziekenhuis, Gent, Belgium
  2. 2
    Mariaziekenhuis, Overpelt, Belgium
  3. 3
    Heilig Hart Ziekenhuis, Roeselare-Menen, Belgium
  1. Dr Louis Ide, Jan Palfijn Ziekenhuis, Gent, Belgium; louis.ide{at}

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A 30-year-old black Namibian man was admitted to our hospital suffering from painless subcutaneous nodules on the right side of his trunk after a fall into an acacia tree as a teenager. As a child he had worked in the fields in northern Namibia. All nodules were removed by surgical excision and were described by the surgeon as black lead-shot-like particles sized 1–2 mm. Fascia was left intact. Conventional x rays showed no invasion of the deeper layers. Stained sections (H&E) revealed the typical rust-brown cement-like elements as seen in Madurella mycetomatis grains.13 The typical diffusion of the extracellular pigmented …

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