Barreiros Hugo Marques, Cunha Henriqueta, Bártolo Elvira
Department of Dermatology, Hospital Garcia de Orta, Almada, Portugal.
J Dermatol Case Rep. 2013 Mar 30;7(1):29-30. doi: 10.3315/jdcr.2013.1134.
Botryomycosis is a chronic, granulomatous infection of the skin, soft tissue and viscera. It is uncommon and mainly occurs in immunocompromised patients. Splendore-Hoeppli phenomenon represents an immunological host reaction to antigens of infectious and non-infectious agents. We report a case of a 64-year-old immunocompetent woman presented at our department with a 2-month history of abdominal papules and discharging nodules. She was treated with several antibiotics with no success. Skin biopsy showed granular bodies in the dermis with a Splendore-Hoeppli phenomenon. Microbiologic study isolated a Staphylococcus aureus. Patient was successfully treated 4 weeks with oral clindamycin 300 mg bid. Lack of drug penetration into the "encapsulated-like" microcolonies could explain the therapeutic challenge of this case.
葡萄状菌病是一种皮肤、软组织和内脏的慢性肉芽肿性感染。它并不常见，主要发生在免疫功能低下的患者中。斯普伦多-赫普利现象代表宿主对感染性和非感染性病原体抗原的免疫反应。我们报告一例64岁免疫功能正常的女性患者，因腹部丘疹和排脓性结节2个月前来我科就诊。她接受了多种抗生素治疗但无效。皮肤活检显示真皮中有颗粒体，伴有斯普伦多-赫普利现象。微生物学研究分离出一株金黄色葡萄球菌。患者口服克林霉素300毫克，每日两次，治疗4周后成功治愈。药物无法渗透到“包膜样”微菌落中可能解释了该病例的治疗难题。
