Botryomycosis: a rare mimic of sarcoma as an initial presentation of acquired immunodeficiency syndrome.

Autor: Boone SL; Department of Radiology, Creighton University School of Medicine, Phoenix, AZ, USA. BooneSeanL@gmail.com., Horvai AE; Department of Pathology, University of California San Francisco, San Francisco, CA, USA., Zimel MN; Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USA., Brown R; Morehouse School of Medicine, Atlanta, GA, USA., Link TM; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA., McGill KC; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
Jazyk: angličtina
Zdroj: Skeletal radiology [Skeletal Radiol] 2024 Oct; Vol. 53 (10), pp. 2315-2320. Date of Electronic Publication: 2023 Dec 01.
DOI: 10.1007/s00256-023-04527-w
Abstrakt: Botryomycosis is a rare granulomatous response to chronic bacterial infection most frequently associated with Staphylococcus aureus. This disease, which predominantly affects immunocompromised patients, may present with cutaneous, visceral, or soft tissue manifestations. Soft tissue involvement typically has an aggressive mass-like appearance on imaging which can be concerning for malignancy. In immunocompromised patients, botryomycosis can resemble fungal infection both clinically and histologically; therefore, definitive diagnosis requires tissue sampling along with histological and microbiological analysis. Presented here is a 25-year-old man with an enlarging intramuscular soft tissue mass of the right forearm as his first presentation of undiagnosed acquired immunodeficiency syndrome (AIDS). MR imaging showed a mildly T2 hyperintense and enhancing mass with infiltrative margins extending through tissue planes. Biopsy of the mass revealed Staphylococcus aureus-associated botryomycosis, which improved with nonsurgical treatment employing antibiotics. Unfortunately, the patient subsequently expired from other manifestations of his new AIDS diagnosis. This case describes the MR and PET-CT appearance of botryomycosis and also underscores that infection can mimic sarcoma, particularly in the setting of immunodeficiency.
(© 2023. The Author(s), under exclusive licence to International Skeletal Society (ISS).)
Databáze: MEDLINE
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