LAUSR

DEAR EDITOR, A 60-year old man presented with multiple discharging sinuses, with brownish crusts, over the left orbitotemporal region (a). These symptoms had been present for 1 year following a village mass cataract surgery and the patient had no comorbidities. The lesions began as inflammatory nodules on the upper eyelid 1 month after surgery, which was otherwise uneventful. The patient had received multiple short courses of antibiotics with no improvement. Culture and polymerase chain reaction were negative for fungal, bacterial and mycobacterial organisms. Histopathology (Gram-stain, original magnification 9 100) showed bunches of Gram-positive cocci with the Splendore– Hoeppli phenomenon (arrow head) suggestive of botryomycosis (b). A 4-month course of rifampicin (600 mg per day) and co-trimoxazole (960 mg per day) led to complete remission with no relapse after 6 months. Periorbital botryomycosis is very rare and may pose a diagnostic and therapeutic challenge to dermatologists. M. RAZM I T R . MAHA J AN P . AGRAWAL Department of Dermatology, Venereology and Leprology and Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Correspondence: Rahul Mahajan. E-mail: [email protected]