A pulmonary tumor‐like mass resolving with antibiotics

Botryomycosis is a misnomer derived from the Greek words botrys (‘bunch of grapes’) and mycosis (‘fungus’) (1, 2), but the disease actually is sustained by several different bacteria species, including Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Proteus species, Pseudomonas aeruginosa and Bacillus species among others (3–6). The exact pathogenesis is still debatable and possibly related to immunologic defects (7, 8). The disease is poorly recognized and possibly underrated, but the correct recognition of this condition, through the evidence of dense aggregates of bacteria on small biopsy or cytology and microbiologic cultures, is crucial to rule out malignancy and prevent unnecessary treatments. We report here a case of pathology-proven botryomycosis mimicking malignancy at imaging studies, diagnosed through a transthoracic fine-needle aspiration.