What are the other Names for this Condition? (Also known as/Synonyms)

• Bacterial Pseudomycosis
• Cutaneous Botryomycosis
• Granular Bacteriosis

What is Botryomycosis? (Definition/Background Information)

• Botryomycosis is a very rare and chronic bacterial infection that mostly affects the skin, and sometimes, the internal organs such as the lungs. The most common bacterium associated with this infection is Staphylococcus aureus followed by Pseudomonas aeruginosa
• Botryomycosis may affect individuals of any age category. The infection is treated using long duration antibiotic therapy. With adequate and prompt treatment, the prognosis of the condition may be good

Who gets Botryomycosis? (Age and Sex Distribution)

• Botryomycosis may affect both children and adults
• Both males and females are affected, and no gender preference is observed
• There is no racial or ethnic preference observed. However, the infection is highly uncommon and only a few cases have been recorded

What are the Risk Factors for Botryomycosis? (Predisposing Factors)

The risk factors for Botryomycosis may include:

• Immunocompromised status - individuals with poor immunity from a variety of factors have an increased risk for the condition. These include:
  • HIV infection and AIDS
  • Organ transplant
  • Chronic alcoholism
  • Uncontrolled diabetes
  • Cystic fibrosis
  • Use of corticosteroids for long durations
• Presence of foreign body
• Surgery
• Trauma

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Botryomycosis? (Etiology)

Botryomycosis is caused by a bacterial infection. However, the method of transmission of the infection is presently unclear.

• The condition is more commonly reported among individuals with weak immune systems
• According to medical literature, Botryomycosis is typically preceded by factors such as trauma, surgery, and foreign body presence

The following pathogens have been implicated:

• Staphylococcus aureus - most common
• Pseudomonas aeruginosa - second most commonly implicated bacterium

Involvement of many other bacterial species have been reported.

What are the Signs and Symptoms of Botryomycosis?

The signs and symptoms of Botryomycosis may include:

• Presence of subcutaneous nodules that ulcerate
• Abscess formation with pus discharge
• The lesions form over many months and discharge yellow grain-like pus
• Wart-like (verrucous) lesions may also be seen
• The infection may cause the formation of fistulas
• Along-with the skin tissues, the infection may progress to involve the muscles and bones

Rarely, involvement of the internal organs (mostly the lungs) is reported, particularly in individuals with deficient immune system.

How is Botryomycosis Diagnosed?

Botryomycosis is uncommon and may be misdiagnosed, unless the healthcare provider has a high index of suspicion for the same. The following tests and exams may be used to diagnose the condition:

• Physical examination and a complete medical history
• Bacterial culture of pus swabs
• Fungal, yeast, and atypical mycobacterial cultures, or other studies
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Botryomycosis?

The possible complications due to Botryomycosis include:

• The infection may spread to other regions and organs
• Severe emotional stress due to cosmetic issues
• Permanent scars and patches
• Superimposed infections
• Involvement of many internal organs
• Treatment complications

How is Botryomycosis Treated?

The treatment measures available for Botryomycosis include:

• Antibiotic therapy may be needed for a prolonged period
• Surgical debridement of the lesions, including drainage of pus
• Laser vaporization of lesions
• Self-care may be undertaken through:
  • Keeping the skin clean
  • The areas around the lesions should be gently washed with soap and running water
  • Wearing gloves while applying topical creams and ointments
• Hospitalization may be necessary for individuals with severe infections and/or complications

Regular follow up visits with the healthcare provider is important and recommended.

How can Botryomycosis be Prevented?

Presently, it may be difficult to prevent some cases of Botryomycosis. However, an individual’s risk for the infection may be lowered through the following measures:

• Getting treatment for any underlying medical condition(s) that may decrease immunity in the individual
• Maintaining good personal and body hygiene
• Frequent handwashing

What is the Prognosis of Botryomycosis? (Outcomes/Resolutions)

The prognosis of Botryomycosis infection may be good with early appropriate treatment.

Additional and Relevant Useful Information for Botryomycosis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/