Mycetoma is a chronic subcutaneous infection that develops after one of the multiple etiologic microorganisms is inoculated into a site of skin trauma. Although mycetoma is primarily a subcutaneous disease, it can involve bone and lymph nodes by contiguous spread. Mycetoma shows three clinical characteristics: tumor, sinuses, and grains. The tumor results as a consequence of a progressive and relatively painless swelling. Sinuses are a characteristic of the disorder; they can be absent in early stages, but later develop and drain purulent material and grains. Grains are colonies of the causative agent and can be black, white, or red. Mycetoma can be caused by a variety of fungal agents (eumycetoma), or filamentous gram-positive branching bacteria belonging to the aerobic Actinomycetales (actinomycetoma).