|Year : 1994 | Volume
| Issue : 2 | Page : 108-109
C Arun Inamdar, SJ Nagalotimath
C Arun Inamdar
Source of Support: None, Conflict of Interest: None
A 20 year female with botryomycosis is reported. Good response to antibiotics and surgical resection is observed.
|How to cite this article:|
Inamdar C A, Nagalotimath S J. Botryomycosis. Indian J Dermatol Venereol Leprol 1994;60:108-9
| Introduction|| |
Botryomycosis is a chronic granulomatous reaction to bacterial infection, containing granules resembling the sulfur granules of actinomycosis. Most cases are caused by Staphylococus aureus. 
| Case Report|| |
Adult female aged 20-years-presented with history of painful swelling over left shoulder of 10 months duration. There was history of preceding trauma while working in the field. Swelling started as `boil like' lesion, later progressing with multiple discharging sinuses. There was intermittent history of constitutional symptoms like fever and malaise. There was no history of any chronic illness.
Cutaneous examination revealed indurated tender nodular mass with discharging sinuses over the left deltoid area [Figure - 1]. Routine culture from discharge and biopsy tissue grew staph aureus. ZN stain for AFB was negative. KOH preparation and fungal culture was negative for fungal element. Routine haematological and urine examinations did not reveal any abnormality. HIV antibody test was negative. Biopsy showed typical features of botryomycosis like masses of cocci, [Figure - 2] with surrounding
lymphohistiocytic and foreign body giant cell tissue reaction. Radiological examination of chest and left shoulder did not reveal any abnormality. Patient was treated with surgical resection and cloxacillin with excellent result.
| Comments|| |
There are 2 forms of botryomycosisprimary cutaneous form with single or multiple abscesses of skin and subcutaneous tissue breaking down to discharge serous fluid through multiple sinuses; pulmonary form may reach the skin and present as irregular masses with multiple sinuses, usually associated with cystic fibrosis. 
Among patients with cutaneous botryomycosis, diabetes, chronic mucocutaneous candidiasis with T cell deficiency, systemic corticosteroid therapy and transient T cell impairment have been reported, but the majority of patients show no such predisposing factors.  There was no evidence of any predisposing factor in present case except history of preceding trauma. A history of injury is common in cutaneous form, which stress the importance of a foreign body as well as infection. 
Scanning of available Indian literature revealed scarce reporting of botryomycosis. ,,sub In all of them staph aureus was common organism grown with good response to antibiotics and surgical resection.
| References|| |
|1.||Roberts SOB, Highet AS. Bacterial infections. In: Text Book of Dermatology (Rook AJ, Wilkinson DS, Ebling FJG, et al, eds), London: Blackwell Scientific publications, 1988; 788-9. |
|2.||Pavitran K. Staphylococcal botryomycosis of the glans penis. Ind J Dermatol venereol leprol 1988; 54 : 216-7. |
|3.||Kadyan RS. Botryomycosis - 2 case reports. VII International Congress of Dermatology, New Delhi, India, 1994 (Book of Abstracts). |
|4.||Aronstain NE. Human botryomycosis with case report. Ind J Dermatol 1936; 2 : 39 (Quoted in IJDVL cumulative index, supplement, 1994; 601:10). |
[Figure - 1], [Figure - 2]