Botryomycosis: Delayed Diagnosis Complicates Treatment

Botryomycosis is a chronic bacterial infection that is mostly caused by Staphylococcus aureus. More commonly, this rare disease affects the skin, and less often the viscera. In this case, we will discuss a 64 year old male that was undiagnosed with botryomycosis for over two years. Punch biopsy and culture revealed heavy growth of Staphylococcus aureus infection with scar tissue, which confirmed the diagnosis of botryomycosis. The patient was treated with dicloxacillin 500 mg one pill three times daily for two weeks and then another round for ten more days. This therapy was followed by doxycycline 100 mg twice daily for four weeks and surgical debridement. In this case report, the need for early and accurate diagnosis of botryomycosis will be emphasized due to the vast differing cutaneous presentations of this disease, thus preventing the delay of diagnosis and treatment.