Extensive botryomycosis in a patient with diabetes and chronic active hepatitis

Extensive botryomycosis was diagnosed in a patient with diabetes mellitus with chronic active hepatitis. Peptostreptococcus organisms and Staphylococcus aureus grew from the sulfur granule cultures. The patient's neutrophils showed notable inhibition of chemotaxis toward endotoxin-activated normal serum. The patient's serum also had an inhibitor to neutrophil chemotaxis, This inhibiting substance was probably antistreptolysin O. Results of other tests of neutrophil function and skin tests to evaluate cell-mediated immunity were normal.