Pulmonary botryomycosis

Abstract

Botryomycosis is a rare, chronic suppurative granulomatous bacterial infection of skin, soft tissue, and viscera with aggregates of nonbranching gram positive or negative bacteria. This is a very rare infection usually under diagnosed, mostly seen in immunocompromised state, so far only few case reports were reported worldwide. 59-year-old gentleman from Port Blair, with no comorbidities came with complaints of cough with expectoration for past six months who already received multiple treatments outside. On examination, he had basal crepitation’s in right infrascapular area. His chest X-ray showed right lower zone opacity. Blood investigation revealed leukocytosis with elevated ESR. HRCT Chest revealed right lower lobe consolidation. Bronchoscopy was done which showed mobile intrabronchial mass in RLL-CBS. Following removal, he improved. Histopathological examination of foreign body revealed vegetative material and showed gram negative bacteria with interspersed gram-positive bacteria surrounded by splendore-hoepplii phenomenon suggestive of botryomycosis. He was treated with antibiotics and he improved well.

Keywords

• botryomycosis
• chronic pneumonia
• splendore-hoepplii phenomenon
• chronic antibiotics.