Botryomycosis: A Case Series and Literature Review in Mexico

Botryomycosis is a rare chronic bacterial infection caused by non-filamentous organisms, characterized by nodular or fistulous lesions with purulent exudate and the presence of grains that may mimic other granulomatous infections. The most commonly isolated causative agent is Staphylococcus aureus, although several other species have been reported. Because it may be mistaken for deep mycoses or neoplasms, diagnosis relies on histopathological examination, microbiological cultures with antimicrobial susceptibility testing, and, when available, molecular or proteomic identification methods. Three cases of botryomycosis affecting different anatomical locations are presented, describing their diagnostic approach and the medical-surgical treatment employed. The importance of considering this entity in the differential diagnosis of chronic granulomatous dermatoses is emphasized. This case series also expands the available evidence on this disease in Mexico, where only 16 cases, including the present series, have been documented in the medical literature.