Botryomycosis in a lung cavity.

Area of Science:

• Medicine
• Infectious Diseases
• Pulmonology

Background:

• Botryomycosis is a rare pyogranulomatous bacterial infection affecting skin, soft tissues, and viscera.
• Pulmonary botryomycosis is exceptionally rare, with few reported cases, and even fewer involving lung cavities.
• Cutaneous botryomycosis accounts for the majority of reported cases.

Purpose of the Study:

• To report a unique case of primary pulmonary botryomycosis within a lung cavity.
• To highlight the first documented instance of this condition in India.
• To discuss the diagnostic challenges and treatment implications of pulmonary botryomycosis.

Main Methods:

• Case presentation of a 62-year-old female with recurrent hemoptysis.
• Diagnostic imaging including CT chest revealing an 'Air Crescent' sign and a suspected fungal ball.
• Surgical intervention involving left upper pulmonary lobectomy and subsequent histopathological and microbiological analysis.

Main Results:

• Histopathology confirmed Splendore-Hoeppli phenomenon and features consistent with botryomycosis.
• Culture of the cavitary specimen identified Pseudomonas aeruginosa as the causative agent.
• Radiological findings mimicked Aspergilloma, presenting a diagnostic challenge.

Conclusions:

• Primary pulmonary botryomycosis in a lung cavity is an exceedingly rare condition.
• The radiological appearance can closely resemble Aspergilloma, necessitating thorough investigation.
• Effective management typically involves a combination of medical and surgical approaches.