Skin-nontumor - Botryomycosis

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Skin-nontumor

Infectious disorders

Botryomycosis

Reviewer: Cecilia Rosales, M.D., Baylor College (see Reviewers page)
Revised: 1 July 2011, last major update July 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● Chronic pyogranulomatous lesion by sulfur granules resembling actinomycosis (Ann Trop Med Parasitol 2004;98:623), but actually due to Staphylococcus aureus and occasionally other organisms (Hum Pathol 2005;36:117, Clin Exp Dermatol 2008;33:266)
● Often associated with depressed immune systems (Nephrol Dial Transplant 1998;13:3200)

Terminology
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● The disease was originally discovered by Otto Bollinger in 1870, and its name was coined by Sebastiano Rivolta in 1884
● The name refers to its grape-like granules (Greek: botryo = grapes) and the mistakenly implied fungal etiology (Greek: mykes = fungus)
● In 1919 the bacterial origin of the infection was discovered

Etiology
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● Staphylococcus aureus is usually the causative organism, however, it can also be caused by Pseudomona aeroginosa or several other species of bacteria
● The anatomic structure resembles actinomycosis and mycetoma, and its granules resemble the sulfur granules of actinomycosis
● It is usually described in individuals with impaired immunity or with an underlying disease such as diabetes mellitus, cystic fibrosis or HIV infection

Case reports
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● 51 year old man in Brazil with progressive lesion of leg (An Bras Dermatol 2009;84:396)

Treatment
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● Excision and antimicrobial therapy (J Rheumatol 2006;33:2545, J Eur Acad Dermatol Venereol 2003;17:87)

Clinical images
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51 year old man in Brazil with progressive lesion of leg

Micro description
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● The lesion is similar to that of actinomycosis and mycetoma, and its granules resemble the sulfur granules of actinomycosis

Micro images
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Images contributed by Dr. Angel Fernandez-Flores, MD, PhD, Hospital El Bierzo and Clinica Ponferrada, Spain

51 year old man in Brazil with progressive lesion of leg

Patient with chronic leg ulcers - lesion has Splendore-Hoeppli phenomenon, a characteristic brightly eosinophilic peripheral band

End of Skin-nontumor > Infectious disorders > Botryomycosis

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