Botryomycosis.

Area of Science:

• Dermatology
• Infectious Diseases
• Microbiology

Background:

• Botryomycosis is a rare, chronic bacterial granulomatous disease primarily affecting the skin.
• Staphylococcus aureus is the most common cause, though other bacteria like Escherichia coli can be involved.

Purpose of the Study:

• To report a rare case of polymicrobial botryomycosis on the forehead and scalp.
• To describe the diagnostic and therapeutic challenges encountered in managing this complex infection.

Main Methods:

• A 32-year-old male presented with polymicrobial botryomycosis.
• Initial cultures identified Staphylococcus aureus, treated with cefadroxyl/clavulanic acid, rifampicin, and linezolid.
• Repeat cultures revealed Escherichia coli, necessitating a change in treatment.

Main Results:

• Partial resolution was achieved with initial antibiotic therapy.
• Subsequent treatment with injectable netilmycin and oral sulfamethoxazole/trimethoprim, alongside surgical debridement, led to slow but steady resolution.
• The case highlights the importance of repeat cultures and tailored combination therapy.

Conclusions:

• Polymicrobial botryomycosis requires a multi-faceted treatment approach.
• Surgical debridement combined with appropriate antibiotic therapy is crucial for managing complex cases.
• This case underscores the variability in causative agents and the need for prolonged treatment.