Asunto(s)
Dolor en el Pecho/etiología , Infarto del Miocardio/diagnóstico , Neurofibromatosis 1/diagnóstico , Piel/patología , Adulto , Biopsia , Aneurisma Coronario/diagnóstico por imagen , Aneurisma Coronario/etiología , Angiografía Coronaria , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/etiología , Diagnóstico Diferencial , Electrocardiografía , Femenino , Humanos , Mutación Missense , Infarto del Miocardio/complicaciones , Neurofibromatosis 1/complicaciones , Neurofibromatosis 1/genéticaRESUMEN
Sporotrichosis is an infection caused by the dimorphic fungus Sporothrix schenckii and related species that often arises from traumatic inoculation of inhabited soil and organic debris into skin. The infection is usually limited to the skin in immunocompetent patients, usually as lymphocutaneous sporotrichosis. Accurate diagnosis rests on clinical data and culture, and might be facilitated by biopsy identification of suppurative and granulomatous inflammation with fungal elements. In this Grand Round, we present a dramatic case of cutaneous sporotrichosis initially presented with an atypical large ulcer without associated lymphocutaneous spread, clinically mimicking pyoderma gangrenosum, and subsequently progressed to disseminated sporotrichosis in the setting of iatrogenic immunosuppression. We further review the clinical features, risk factors, and treatment of these disseminated sporotrichosis cases, and discuss the need for improved awareness of this fungus' potential link to cause disseminated and invasive fungal infections.