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Background <p>Botryomycosis is a rare chronic bacterial infection characterized by suppuration and granulomatous inflammation. Although its name misleadingly suggests a fungal etiology (from the Greek <i>myces</i>, “fungus”), botryomycosis is a bacterial infection caused by non-filamentous organisms, most commonly <i>Staphylococcus aureus</i> or <i>Pseudomonas</i> spp., that form characteristic pseudomycotic granules. While approximately 75% of cases affect the skin, visceral involvement occurs in about 25% of cases, with hepatic localization being exceptionally uncommon.</p> Case presentation <p>A 50-year-old man presented with hepatomegaly and multiple hepatic cysts. Initial clinical suspicion included neoplasia and parasitic infection. Fine-needle aspiration (FNA) of the hepatic lesions revealed basophilic, rounded bacterial aggregates (“botryoid clusters”), with focal areas demonstrating a Splendore-Hoeppli reaction, indicative of botryomycosis.</p> Conclusion <p>FNA cytology enabled a definitive, minimally invasive diagnosis of hepatic botryomycosis, an exceptionally rare condition, thereby preventing misdiagnosis as neoplasia or other granulomatous diseases.</p>

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Botryoid clusters in a hepatic cystic lesion: a clue to botryomycosis?

  • 期刊论文

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  • 发表日期：

    2026年1月23日

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  • Suzana Bastos Batista,
  • Juliana Lins Maués,
  • Hercílio Fronza Junior,
  • Raquel Francine Liermann Garcia,
  • Jaqueline Stall,
  • Camila Barbosa,
  • José Guilherme Jasper Pickler,
  • Francis Rossetti Pedack,
  • Bruna Louise Silva,
  • Paulo Henrique Condeixa de França,
  • Karina Munhoz de Paula Alves Coelho

摘要

Background

Botryomycosis is a rare chronic bacterial infection characterized by suppuration and granulomatous inflammation. Although its name misleadingly suggests a fungal etiology (from the Greek myces, “fungus”), botryomycosis is a bacterial infection caused by non-filamentous organisms, most commonly Staphylococcus aureus or Pseudomonas spp., that form characteristic pseudomycotic granules. While approximately 75% of cases affect the skin, visceral involvement occurs in about 25% of cases, with hepatic localization being exceptionally uncommon.

Case presentation

A 50-year-old man presented with hepatomegaly and multiple hepatic cysts. Initial clinical suspicion included neoplasia and parasitic infection. Fine-needle aspiration (FNA) of the hepatic lesions revealed basophilic, rounded bacterial aggregates (“botryoid clusters”), with focal areas demonstrating a Splendore-Hoeppli reaction, indicative of botryomycosis.

Conclusion

FNA cytology enabled a definitive, minimally invasive diagnosis of hepatic botryomycosis, an exceptionally rare condition, thereby preventing misdiagnosis as neoplasia or other granulomatous diseases.