Abstract
We report a rare case of mycetoma after renal transplant in a patient with distant exposure to mangroves during disaster relief efforts in the Caribbean. Histopathology and fungal culture from the skin biopsy revealed findings consistent with chronic mycetoma caused by a dematiaceous mold. Next Generation Sequencing (NGS) identified the organism as closely related to Raghukumaria keshaphalae, a fungus originally isolated from mangroves. This case highlights the emerging threat posed by environmental dematiaceous fungi as obscure opportunistic pathogens in the setting of natural disasters, especially for immunocompromised patients, and the pivotal diagnostic role of NGS in invasive fungal infections.