In 1901, Brumpt described the first recorded case of mycosis caused by M. mycetomatis, identifying black granules in association with mycetoma.

Roughly a dozen other species of uncertain validity have been described as genus Madurella based on in vivo similarities and cultural sterility.

This showed that M. mycetomatis is not genetically homogenous, and explained the variability in host symptoms affected by the same etiological agent.

The melanin produced by the fungus has also been identified as a defense mechanism against processes such as hydrolytic enzymes, free radicals, redox buffering, antibodies and complement.

Following the initial stage, brownish aerial mycelia (1 to 5 μm) form and the colony starts producing a diffusible pigment called pyomelanin, and becomes smooth in texture.

In nutritionally deficient or potato-carrot media, black grains (0.75 to 1 mm in diameter) with undifferentiated polygonal cells can be observed.

The most common type is compact or filamentous, where a dark brown cement like amorphous, electron rich substance fills the voids surrounding the hyphal network.

In contrast, the second type, vesicular, has a light colored medulla and a brown cortical region filled with hyphae and vesicles 6 to 14 μm in diameter.

This type is characterized by small spherical conidia (3 μm in diameter) on tapered tips of flask shaped phialides and collarettes.

[6] Madurella mycetomatis is the most common fungus with respect to causing mycetoma in humans,[14] a chronic localized inflammatory disease.

[3] Cases of mycetoma caused by this fungus have also been reported in West Africa, India, Venezuela, Curaçao, Brazil, Peru and Argentina.

[9] Infected hosts from samples in Sudan show variability in clinical symptoms, this corroborates the heterogeneity of M. mycetomatis genotypes.

[16] Additionally, molecular analysis lead to the determination that M. mycetomatis did not share a common ancestor with M. grisea, and belonged in the Sordariales class.

[3] Understanding how a fungus might react to various anti-fungal agents in-vitro can be beneficial when wanting to study or isolate particular organisms in culture.

The Clinical & Laboratory Standards Institute (CLSI) M38A methods indicate that conidial suspensions are to be used when testing anti-fungal susceptibility of filamentous fungi.