Cutaneous botryomycosis. Report of the two first Uruguayan cases: relato dos dois primeiros casos no Uruguai

Resumo: Botriomicose é infecção bacteriana crônica, granulomatosa, supurativa, que afeta a pele e os tecidos subcutâneos. Caracteriza-se por lesão cutânea com múltiplas fístulas, que drena secreção purulenta, na qual se encontram grãos branco-amarelados, PAS-positivos. O principal agente etiológico é o Staphylococcus aureus, e outros germes menos frequentes são Pseudomonas aeruginosa, Escherichia coli, isolados ou associados. Os autores relatam um caso da doença, com lesões exuberantes de consistência fibrosa e múltiplos orifícios fistulosos dos quais drenavam grãos branco-amarelados, localizadas na perna direita e provocando aumento de volume do membro, que tiveram resolução com sulfametoxazol-trimetoprim. Palavras-chave: Bactérias; Granuloma; Staphylococcus aureus Abstract: Botryomycosis is a chronic, granulomatous, suppurative bacterial infection involving the skin and subcutaneous tissues. The skin lesion is characterized by multiple fistulae draining purulent secretion with white-yellowish grains PAS positive. The main etiologic agent is Staphylococcus aureus and other less frequent pathogens are Pseudomonas aeruginosa and Escherichia coli, isolated or associated. The authors report a case of this disease with exuberant lesions on the right leg and increased limb volume, fibrous consistency and multiple fistula orifices draining white-yellowish grains. INTRODUÇÃOA botriomicose é infecção bacteriana granulomatosa, rara, crônica e supurativa da pele e das vísce-ras, caracterizada pela liberação de grãos, como os presentes no micetoma e na actinomicose. 1As lesões cutâneas podem ser únicas ou múlti-plas e pleomórficas, semelhantes a cistos, abscessos, fístulas, nódulos, placas ou úlceras. Geralmente localizam-se nas áreas expostas a traumas (cabeça, braços, pernas) e genitais.1, 2 Os músculos, aponeuroses, tendões e ossos também podem estar envolvidos. A aparência geral de lesão tumefeita e supurativa sugere inoculação local de corpo estranho como causa inicial da infecção e perpetuação da doença. 1Inicialmente foi considerada infecção fúngica, motivo que originou o termo botriomicose (do grego: botrys -cachos de uvas, mycosis -origem fúngica). Posteriormente, com a descoberta de sua causa bacteriana, outras denominações surgiram como: actinofi- CASO CLÍNICO

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Pseudomonas Skin Infection

Chan

Metelitsa

et al. 2011

American Journal of Clinical Dermatology

131

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Pseudomonas aeruginosa is a Gram-negative bacillus that is most frequently associated with opportunistic infection, but which can also present in the otherwise healthy patient. The range of P. aeruginosa infections varies from localized infections of the skin to life-threatening systemic disease. Many P. aeruginosa infections are marked by characteristic cutaneous manifestations. The aim of this article is to provide a comprehensive synthesis of the current knowledge of cutaneous manifestations of P. aeruginosa infection with specific emphasis on clinical features and management. The ability of P. aeruginosa to rapidly acquire antibacterial resistance is an increasingly well recognized phenomenon, and the correct application of antipseudomonal therapy is therefore of the utmost importance. A detailed discussion of currently available anti-pseudomonal agents is included, and the benefits of antimicrobial combination therapy versus monotherapy are explored. Rapid clinical recognition of P. aeruginosa infection aided by the identification of characteristic cutaneous manifestations can play a critical role in the successful management of potentially life-threatening disease.

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Cutaneous botryomycosis. Report of the two first Uruguayan cases: relato dos dois primeiros casos no Uruguai

Cited by 3 publications

References 5 publications

Cutaneous Botryomycosis and Staphylococcus aureus: Diagnosis, Management, and a Systemic Literature Review

Cutaneous Botryomycosis and Staphylococcus aureus: Diagnosis, Management, and a Systemic Literature Review

Botriomicose cutânea: relato de caso

Pseudomonas Skin Infection

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