Cutaneous botryomycosis: a comprehensive review

Cutaneous botryomycosis is a chronic, granulomatous infection of the skin caused by different bacteria that form granular aggregates. We aim to provide a complete, comprehensive, and updated review of cutaneous botryomycosis, including a review of cases published in the last decade.

Patients with botryomycosis typically present multiple nodules, sinuses, abscesses, fistulae, and ulcers, which develop during weeks or months. The current gold standard for diagnosing botryomycosis involves a combination of histopathological examination and microbial culture. A definitive diagnosis is established when clinical and pathological findings align with the presence of botryomycosis, supported by the identification of non-filamentous bacteria forming granules and positive culture. The most frequent isolated etiological agents are Staphylococcus aureus followed by Pseudomonas aeruginosa. The differential diagnosis includes mycetoma, actinomycosis, and carcinomas/sarcomas. Treatment includes antibiotics and, in selected cases, surgical debridement.