Botryomycosis in a patient with acquired immunodeficiency syndrome

Botryomycosis is a bacterial infection of either the skin alone or in combination with visceral organs. It resembles a deep fungal infection. A histologic evaluation of cutaneous lesions reveals the characteristic Splendore-Hoepple phenomena and assists with management. Patients with acquired immunodeficiency syndrome (AIDS) tend to have uncharacteristic lesions resembling common conditions such as prurigo nodularis and lichen simplex chronicus. Diagnosis in these cases can be challenging. We report the case of a patient with AIDS who was successfully treated with Augmentin (amoxicillin, clavulanate potassium). Complete resolution of the lesion occurred after the causative agent, Staphylococcus aureus, was identified.