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Botryomycosis in acquired immunodeficiency syndrome
Archives of Pathology & Laboratory Medicine
|March 1, 1987
Summary
This study reports the first integumentary botryomycosis case in an immunocompromised homosexual man. Findings suggest a macrophage defect in killing gram-positive cocci, leading to botryomycosis.
Area of Science:
- Medical Mycology
- Immunology
- Infectious Diseases
Background:
- Botryomycosis is a rare bacterial infection typically affecting the skin and subcutaneous tissues.
- Acquired immunodeficiency syndrome (AIDS) compromises the immune system, increasing susceptibility to opportunistic infections.
Observation:
- A homosexual man with AIDS developed anal fistula and abscesses after severe cryptosporidial diarrhea.
- Suppurative exudate revealed characteristic 'grains' composed of gram-positive cocci.
- These grains were observed attached to and within multinucleated macrophages.
Findings:
- The study postulates that gram-positive cocci survive and replicate within macrophages.
- Macrophages may extrude these cocci as grains, indicating a failure in intracellular killing mechanisms.
- This suggests a potential defect in the monocyte-macrophage system's ability to eliminate bacteria.
Implications:
- This case highlights a novel presentation of botryomycosis in an immunocompromised individual.
- The findings suggest a link between macrophage dysfunction and the pathogenesis of botryomycosis.
- Further research may explore the role of T4-inducer subsets in controlling macrophage activity against bacterial infections.