Cutaneous Botryomycosis Due to a Donkey Bite: A New Case
Journal Title: Scholars Journal of Medical Case Reports - Year 2018, Vol 6, Issue 12
Abstract
Botryomycosis is a chronic granulomatous bacterial infectious suppurated pathology. It is rare and can be localized on the skin and the viscera. The predisposing factor is most often a trauma. This case is about a 28 year-old patient with no particular pathological history, who was bitten by a donkey at the age of 7, on the anterior side of the right leg. For the last 10 years, she had a right lower limb swelling, made of an atypical prurigo nodular-like, suppurative lesion with fistulas. There is also a functional impotence of the limb. The mycological samples returned sterile. Bacteriological analysis of cutaneous biopsies showed Staphylococcus aureus. Histological examination revealed granulomatous grain abscess infection, suggestive of more bacterial grains, in favor of a botryomycosis. The patient was treated with bi-antibiotic therapy adapted to the sensitivity of S. aureus, including ciprofloxacin and sulfamethoxazole / trimethoprim. We also added weekly applications of trichloroacetic acid at 50% at the vegetative fistula lesions, with good results after 4 months of treatment. Cutaneous botryomocosis is a rare and underrated unit. Our case is particular because the donkey bite has not yet been described as being responsible for botryomycosis. Trauma such as a snake bite, intravenous long-term infusion, and a fork injury were reported. Making diagnosis may be difficult as it requires clinical, biological and especially histological features. Differential diagnosis must be eliminated, especially fungal mycetoma and actinomycosis. Staphylococcus aureus is the most incriminated, but there are often several germs at the same time (aerobic / anaerobic) which makes it difficult to sterilize the lesions. Histopathologic findings, like an inflammatory infiltrate made of granuloma with basophilic center of granular mass and eosinophilic periphery (called: Splendore-Hoeppli phenomenon, non-pathognomonic), with a clinical history may help for the diagnosis. Finally, antibiotic therapy might help sometimes to sterilize lesions but in this case, trichloroacetic acid seemed effective in drying lesions.
Authors and Affiliations
Razanapinaritra R, El Fetoiki FZ, Regragui M, Mernissi F, Hali F, Chiheb S
Keywords
Related Articles
- EP ID EP489985
- DOI -
- Views 85
- Downloads 0
Ossifying Fibroma Presenting As a Nasal Mass: A Diagnostic Dilemma
Ossifying fibroma (OF) is a benign, slow-growing, central bone tumor, usually of the jaws, especially the mandible, composed of fibrous connective tissue within which bone is formed. The overlapping clinical and histopa...
Organophosphate Induced Neuropathy: A Case Report
Organophosphorus (OP) compounds constitute a heterogeneous category of chemical agents with wide-spread use throughout the world, mainly in agriculture. The ability of some of these chemicals to cause an irreversible, pr...
A Case of Eyelid Epidermoid Cyst
Epidermoid cysts are slow growing, benign tumors that result from proliferation of epidermal cells within a confined space. Eyelid is one of the unusual locations for epidermoid cyst. Previously, they were often diagnose...
Successful Percutaneous Transcatheter Device Closure of Ruptured Sinus of Valsalva Aneurysm
Ruptured Sinus Of Valsalva (RSOV) is a rare but clinically well recognized entity which predominantly affects adolescent males caused by congenital weakness in the aortic media leading to progressive dilatation of sinus...
Human Immunodeficiency Virus Associated Pulmonary Arterial Hypertension: An uncommon etiology of Pulmonary Hypertension
Pulmonary arterial hypertension has a deadly association with Human immunodeficiency virus infection. The incidence of pulmonary hypertension in Human immunodeficiency virus infection is higher than those in general popu...