Which of the following is false about mycetoma -

Mycetoma - A chronic, slowly progressive granulomatous infection of the skin and subcutaneous tissues. Caused by actinomycetes and filamentous fungi Clinically, it is manifested as triad of swelling, discharging sinuses and presence of granules in the discharge. Can affect lower and upper extremities 2. Laboratory Diagnosis: Diagnosis is by examination of pus / discharge - Direct Examination: Granules are thoroughly washed in sterile saline; crushed between the slides and examined Epidemiology: - Mycetoma is endemic in Africa, India and the Central and South Americas. - Overall, actinomycetoma is more common (60%) than eumycetoma (40%) globally.