Cutaneous Botryomycosis in Immunocompetent Patients: A Case Series

Botryomycosis is a rare chronic suppurative bacterial infection of skin and viscera mostly reported in immunocompromised adults. Most of published literature on botryomycosis are case reports. Though morphological presentation of cutaneous botryomycosis has been described as nodules, sinus, abscesses, and ulcers discharging seropurulent exudates, sequential evolution of lesions is not clear. We report a series of three cases of cutaneous botryomycosis in immunocompetent patients (one child and two adults). Two cases had localized lesion, while adult male had lesions in a sporotrichoid distribution. In all cases the lesions evolved in the form of appearance of subcutaneous swelling which later on developed multiple nodules and papules on surface which either developed erosion, ulceration or sinus on surface associated with seropurulent discharge. The organisms isolated from discharge and tissue culture were coagulase negative staphylococcus and methicillin sensitive staphylococcus aureus. All cases were treated with monotherapy of sensitive systemic antibiotic. Two patients fully recovered and one lost to follow-up in the middle of therapy.