Facial botryomycosis-like pyoderma in an HIV-infected patient: remission after initiation of darunavir and raltegravir

• Published in: Revista da Sociedade Brasileira de Medicina Tropical Vol. 50; no. 2; pp. 277 - 279
• Main Authors: Eyer-Silva, Walter de Araujo, Silva, Guilherme Almeida Rosa da, Ferry, Fernando Raphael de Almeida, Pinto, Jorge Francisco da Cunha
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Medicina Tropical 01-03-2017; Sociedade Brasileira de Medicina Tropical - SBMT; Sociedade Brasileira de Medicina Tropical (SBMT)
• Subjects: Adult; AIDS; AIDS-Related Opportunistic Infections - diagnosis; AIDS-Related Opportunistic Infections - drug therapy; Alcoholism; Anti-HIV Agents - therapeutic use; Antiinfectives and antibacterials; Antiretroviral agents; Antiretroviral drugs; Bacteria; Botryomycosis; Botrytis - isolation & purification; Case reports; Cell-mediated immunity; Cheek; Chronic infection; Darunavir - therapeutic use; Defects; Dermatomycoses - diagnosis; Dermatomycoses - drug therapy; Drug abuse; Facial Dermatoses - diagnosis; Facial Dermatoses - drug therapy; Female; HIV; HIV infection; Human immunodeficiency virus; Humans; Immunity; Immunology; Pyoderma; Pyoderma - diagnosis; Pyoderma - drug therapy; Raltegravir Potassium - therapeutic use; Remission; Remission (Medicine); Sinus; Sinuses; Skin; Therapy; Tissues; Trauma; TROPICAL MEDICINE; AIDS; HIV infection; Botryomycosis
• ISSN: 0037-8682; 1678-9849; 1678-9849; 0037-8682
• DOI: 10.1590/0037-8682-0061-2016

Botryomycosis is an uncommon, chronic, suppurative, bacterial infection that primarily affects the skin and subcutaneous tissues. It has long been associated with defects of cellular immunity. We report a 28-year-old woman who presented with a chronic, ulcerated lesion with draining sinuses in the right malar region. Predisposing factors were HIV infection with poor immunological control, alcoholism, and a previous trauma to the right cheek. Several courses of antimicrobial therapy provided only partial and temporary remission. Complete clinical remission was only achieved 5 years later when a novel antiretroviral regimen composed of darunavir and raltegravir was initiated.