Rare Mycetoma Caused by Raghukumaria species, a Mangrove-Derived Dematiaceous Fungus in a Kidney Transplant Patient

A 50-year-old renal transplant patient developed a forearm mycetoma after exposure to mangrove water during disaster relief efforts in the Caribbean. Histopathology and fungal culture from the skin biopsy revealed findings consistent with chronic mycetoma caused by dematiaceous molds. Next Generation Sequencing (NGS) identified the organism as closely related to Raghukumaria keshaphalae, a fungus originally isolated from mangrove environment. This case highlights the role of tropical regions as reservoir for dematiaceous molds, the threat posed by environmental fungi as opportunistic pathogens in the setting of natural disasters and the pivotal diagnostic role of NGS in invasive fungal infections.