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Year : 1995  |  Volume : 61  |  Issue : 3  |  Page : 179-180

Actinophytosis (botryomycosis) due to staphylococcus aureus in a patient with diabetes mellitus

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K V Ingole

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PMID: 20952945

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How to cite this article:
Ingole K V, Jalgaonkar S V, Fule R P. Actinophytosis (botryomycosis) due to staphylococcus aureus in a patient with diabetes mellitus. Indian J Dermatol Venereol Leprol 1995;61:179-80

How to cite this URL:
Ingole K V, Jalgaonkar S V, Fule R P. Actinophytosis (botryomycosis) due to staphylococcus aureus in a patient with diabetes mellitus. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2020 Feb 29];61:179-80. Available from: http://www.ijdvl.com/text.asp?1995/61/3/179/4198

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Mycetoma can be caused by a number of actinomycetes and filamentous fungi. Botryomycosis or actinophytosis caused by Staphylococcus aureus is apparently similar to mycetomas. We report here a 50-year-old lady with diabetes mellitus who presented with a painful swelling between the right great toe and first toe of 4 months duration. A furuncle like lesion had appeared following trauma and had subsequently progressed to multiple discharging sinuses. On examination, the right foot upto the ankle was found to be swollen, indurated and painful, with multiple discharging sinuses and an extensive tunnelling ulcer on the sole. Radiologically there was no bony involvement.

Thus the patient was suspected to have mycetoma and was investigated for a microbial aetiology. Microscopic examination of granules in the purulent discharge showed pus cells and staphylococci and yielded Staph. Aureus on culture. Ziehl-Neelsen staining and fluorescent microscopy did not demonstrate other bacterial pathogens, and fungal culture was negative. Staph. Aureus isolate was sensitive to gentamicin, but resistant to ampicillin, chloramphenicol, tetracycline, penicillin and erythromycin.

The majority of patients of actinophytosis do not have predisposing pathological conditions such as diabetes mellitus, chronic mucocutaneous candidiasis with T-cell dysfunction, systemic corticosteroid therapy and transient T-cell impairment.[1] However, in the present case diabetes mellitus and local trauma were predisposing factors. Botryomycosis is rarely reported as evident from the paucity of related literature.[2][3][4] Staph. Aureus is frequently isolated from such cases. The patient showed speedy recovery with appropriate antibiotic treatment, surgical resection and control of diabetes mellitus. Hence the aetiological diagnosis is important for the management of such cases.

  References Top

1.Roberts SOB, Highet AS. Bacterial infections. In: Textbook of dermatology (Rook AJ, Wilkinson, DS, Ebling FJG, el al, eds). 4th ed. London: Blackwell Scientific Publications, 1988:788-9.  Back to cited text no. 1    
2.Pavithran K. Staphylococcal botryomycosis of the glans penis. Ind J Dermatol Venereol Leprol 1988; 54:216-7.  Back to cited text no. 2    
3.Kadyan RS. Botryomycosis-Two case reports. VII International Congress of Dermatology, New Delhi, India, 1994 (Book of Abstracts).  Back to cited text no. 3    
4.Inamadar AC, Naglotimath SJ. Botryomycosis. Ind J Dermatol Venereol Leprol 1994; 60:108-9.  Back to cited text no. 4    


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