By Gary M. White, MD
Botryomycosis is a chronic granulomatous reaction to bacterial infection, most commonly caused by Staphylococcus aureus, and Pseudomonas sp., which contains granules resembling the sulphur granules of actinomycosis.
A chronic painless, papulonodular lesions is most typical.
Oral antibiotic therapy for weeks to months based upon culture and sensitivities is best. At times, surgical intervention may be needed.
A 32-year-young man with a 1 year history of multiple erythematous fluctuant skin lesions, most of which were discharging purulent material. The lesions were located over forehead and frontal scalp. He had a history of road traffic accident 2 years back with trauma over forehead. Exam showed nodular, cystic, granulomatous, indurated, and tender lesions. Indian J Dermatol. 2013 Sep-Oct; 58(5): 406.