What is botryomycosis?
Botryomycosis is a chronic inflammatory answer to a bacterial infection involving the skin and sometimes the internal organs.
Botryomycosis is a rare condition, with few cases reported worldwide. Because it is so rare, there is confusion in the literature about the classification and definition of the disease. Some authors have suggested that cutaneous botryomycosis is a subtype of pyoderma vegetans, and propose these two conditions should be classified together.
The name is misleading; Botryomycosis is a bacterial infection rather than a fungal infection. "Botryo" is a Latin term for "bunch of grapes". Other authors have suggested that actinomycosis and botryomycosis should be classified under the single term "granular bacteriosis".
What causes botryomycosis?
Staphylococcus aureus is the most commonly implicated, followed by Pseudomonas aeruginosa. Various others bacteria how Proteus or Escherichia coli They have also been isolated.
Some form of trauma, surgery, or the presence of a foreign body generally precedes infection. Botryomycosis is more likely to occur in immunodeficient patients, such as those with HIV infection, alcoholism, cystic fibrosis, prolonged use of corticosteroids and diabetes mellitus.
What are the clinical features of botryomycosis?
Botryomycosis most commonly affects the skin and occurs as subcutaneous noduleslarge abscesses warty injuries ulcers, fistulas and breasts with purulent download. Lesions generally develop over several months and can drain pus. The pus may contain small yellow sulfur-like "grains" granules actinomycosis.
The infection can spread to subcutaneous tissues, muscles, and bones.
Botryomycosis rarely affects the internal organs. The lungs are the most commonly infected and there is generally a predisposing factor such as surgery or impaired immunity.
How is the diagnosis of botryomycosis made?
Botryomycosis can be difficult to diagnose. Diagnosis depends on high clinical suspicion along with microscopy/ /culture to identify typical bacteria and pimples on swabs taken from pus or on the skin biopsy.
The sulfur granules seen in botryomycosis contain bacteria surrounded by a eosinophilic matrix with club-type projections. This histological appearance is commonly known as the Splendore-Hoeppli phenomenon and can be seen using Gram stain, Giemsa stain, or silver stain.
What is the treatment for botryomycosis?
Botryomycosis is treated with:
- Long-term antibiotics, depending on the bacteria identified, include trimethoprim-sulfamethoxazole, oral clindamycin, cephalexin, doxycycline, and erythromycin.
- Surgical drainage and debridement
- To be vaporization