Anjum Kanjee, Saleem Sadiq, Rukhsana Sattar.
Cutaneous Botryomycosis - A case report.
J Pak Assoc Derma Jan ;8(4):35-7.

Botryomycosis is a rate bacterial infection of either the skin alone or with the visceral involvement. It clinically and histologically resembles a deep fungal infection. It is caused by various gram-positive and gram-negative bacteria. On microscopic examination, it is characterized by the presence of granules which resembles the sulphur granules of actinomyces with a granulomatous inflammatory response. We report a case of cutaneous botryomycosis which is a rare disease.

CASE REPORT: A 20 year old male belonging to Baluchistan presented with multiple nodules, discharging sinuses and scarred lesions of 9 years duration. These lesions involved the pubic area and the left leg extending from the inguinal region, anterior aspect of thigh to the calf area. The left inguinal lymph nodes were enlarged, discrete and non-tender on palpation. Apart from the skin problem the patient was otherwise well. There was no past history of any significant medical problem. General physical examination was unremarkable. Histopathological examination showed eosinophilic granules on H and E stained sections. On PAS and Grocott staining, Filamentous elements were not identified. Gram stains demonstrated the presence of gram-positive cocci and gram negative rods within the granule. The patient was treated with a combination of cloxacillin and minocycline according to the culture and sensitivity report.

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