Cutaneous disseminated sporotrichosis associated with diabetes: A case report and literature review.

BACKGROUND: Cutaneous disseminated sporotrichosis (CDS), also called hematogenous sporotrichosis, is a rare condition that usually affects immunocompromised patients. The current work presents the case of a woman with diabetes mellitus associated with CDS. CASE PRESENTATION: A 59-year-old woman with diabetes mellitus presented with a two-year history of ulcerated rashes on the left ankle and both sides of the jaw. Physical examination revealed three annular areas of erythematous and raised plaque with an ulcer over the left ankle and both sides of the jaw. Based on laboratory findings, elevated blood glucose concentration and decreased white cell count were observed. Sporothrix globosa was identified in the mycological culture of biopsied tissue from the three lesions and this was confirmed by DNA sequencing. The skin lesions healed after two-month itraconazole therapy. CONCLUSIONS: Diabetes is a risk factor for disseminated sporotrichosis, which may be induced by hematogeneous spread, repeated inoculation, or autoinoculation. This study raises awareness among clinicians, with regard to the notion that people with possibly altered immune function are potentially vulnerable to severe clinical forms of sporotrichosis.

Sporotrichosis co-infection with human immunodeficiency virus/acquired immunodeficiency syndrome.

Sporotrichosis is a subcutaneous mycosis caused by a dimorphic fungus belonging to the genus Sporothrix. This fungal infection can affect both humans and domestic animals, and in recent years, an increase in the geographic spread and prevalence of sporotrichosis has been observed globally. This systematic review aimed to examine the clinical-epidemiological and therapeutic aspects related to sporotrichosis co-infection with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). An extensive electronic search was conducted on databases including PubMed, Web of Science, Lilacs, Medline, Embase, Scopus and SciELO was performed to identify clinical cases of people living with HIV (PLWH) with sporotrichosis published until May 2023. As a result, we found that most co-infected patients were male, representing 71.76% (94/131) of cases. The most prevalent age group was 41-50 years, with a mean age of 36.98 years. The countries with the highest number of cases were Brazil (75.57%, 99/131) and the United States (16.03%, 21/131). The most frequent clinical presentation was systemic dissemination, accounting for 69.47% (91/131) of the cases, followed by cutaneous dissemination with 13% (17/131). The mean CD4+ cell count was 154.07 cells/µL, and most patients used amphotericin B with at least one azole, which represented 47.33% (62/131) of cases, followed by azole monotherapy in 17.56% (23/131) of cases. As for the outcome, 51.15% (67/131) of the patients remained alive, and 37.4% (49/131) died. Therefore, it was concluded that sporotrichosis in PLWH is a disease with a high prevalence in Brazil and may be associated with systemic clinical manifestations requiring longer periods of systemic antifungal therapy.

Uncommon aetiology of lymphadenopathy in a healthy child: a sporotrichosis case with painless lymphadenopathy.

A 6-year-old boy was referred to the paediatric infectious disease clinic with a 2-month history of enlarged, erythematous, painless cervical lymph nodes. He initially presented to his paediatrician with a painless lesion. At that time, he was treated empirically with clindamycin and azithromycin due to a history of cat exposure. Despite treatment, the lesion evolved into a non-healing linear ulcer with painless, ascending cervical lymphadenopathy. Serologies were negative for Bartonella henselae antibodies. Additional laboratory studies revealed eosinophilia and negative Toxoplasma gondii antibodies. After no improvement following a course of trimethoprim-sulfamethoxazole, further questioning revealed that the patient had fallen into a haystack 1 month before the initial cervical lesion. The patient's parents opted to treat the infection empirically for sporotrichosis with itraconazole rather than undergo lymph node biopsy. At the 2-week follow-up, his lymphadenopathy had resolved and had returned to baseline activity.

Chronic Laryngotracheal Granulomatous Disease Secondary to Sporothrix schenckii in an Immunocompromised Patient.

OBJECTIVE: To describe a rare presentation of laryngotracheal granulomatous disease secondary to sporotrichosis. METHODS: The authors report a case of laryngeal sporotrichosis in an immunocompromised patient, with accompanying endoscopic images and pathology. RESULTS/CASE: A 72-year-old immunocompromised female with a history of rose-handling presented with a year of hoarseness and breathy voice. Flexible nasolaryngoscopy showed diffuse nodularity; biopsy of the lesions demonstrated granulomatous inflammatory changes, and fungal culture grew Sporothrix schenkii. Long-term itraconazole treatment was initiated, with improvement in dysphonia and few residual granulomas on follow-up examination. CONCLUSION: When evaluating granulomatous disease of the airway, a broad differential including infectious or inflammatory etiologies should be considered, especially in immunocompromised patients. Adequate tissue samples should be collected to facilitate special staining. The current recommendations for laryngeal sporotrichosis include treatment with a prolonged course of itraconazole.

Ocular Sporotrichosis with Limbal Stem Cell Deficiency: An Impostor with Blinding Sequelae.

Sporotrichosis is a chronic granulomatous fungal infection caused by Sporothrix schenckii. Inoculation of the fungus through breached skin or mucosa typically results in nodular ulceration of the cutaneous and subcutaneous tissue as well as its draining lymphatic nodules. However, reports on ocular involvement have recently increased. We describe a severe case of diffuse granulomatous conjunctivitis involving bulbar and palpebral conjunctiva, resulting in inevitable damage to the limbal stem cells. Isolation of S. schenckii from a conjunctival swab confirmed the diagnosis of sporotrichosis. A 6-month course of oral antifungal therapy was given through which the patient fully recovered. However, extensive corneal conjunctivalization secondary to total limbal stem cell deficiency has caused almost complete blindness in the affected eye. Clinical suspicion of this zoonotic disease is essential for early diagnosis and prompt treatment to prevent ocular surface complication and blindness.

Case Report: Sweet Syndrome in Patients with Sporotrichosis: A 10-Case Series.

Human sporotrichosis is an emerging disease caused by fungi of the genus Sporothrix, distributed worldwide, but mostly in tropical and subtropical regions. This disease is caused by traumatic inoculation of contaminated material (either animal or vegetal in origin) into the skin. Sporotrichosis cases caused by zoonotic transmission through felines have significantly increased over the last 20 years in Brazil. There is a spectrum of clinical outcomes, from classical lymphocutaneous and fixed forms to disseminated manifestations and extracutaneous lesions; however, hypersensitivity reactions related to sporotrichosis, including Sweet syndrome (acute febrile neutrophilic dermatoses), are uncommon. In Brazil, Sporothrix brasiliensis is repeatedly associated with feline infection and has consistently shown higher virulence, tendency to escalate to outbreaks or epidemics, and development of atypical forms. Therefore, the objective of the present study was to report the cases of 10 patients with sporotrichosis infected by S. brasiliensis species who developed Sweet syndrome to alert this association, especially in endemic areas.

A novel case of cutaneous squamous cell carcinoma at the site of previous sporotrichosis.

BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is a malignant tumor of epithelial keratinocytes, with a relatively reduced frequency of lymph node metastasis. Despite the fact that this tumor type is largely preventable, the incidence of cSCC is rising every year. Ultraviolet exposure is a major cause of cSCC and directly contributes to cSCC. Other known environmental risk factors include ionizing radiation, cigarette smoking, and certain chemical exposures. AIMS: In this study, we report a clinical case of cSCC with a novel causative factor. PATIENT/METHODS: The report describes a 72-year-old male who was seen for a dermatosis condition initially. Later, epidermal hyperplasia and granulomatous inflammation of the dermis was diagnosed based on skin biopsy. Fungal culture revealed the presence of Sporothrix schenckii which led to the diagnosis of fixed-type sporotrichosis. RESULTS: Four months of oral terbinafine (250 mg once a day) administration partially resolved the lesions. Patient was subsequently diagnosed with cSCC, and surgical resection with wider margins was performed. CONCLUSION: After a careful and rigorous exclusion of known risk factors, we confirmed that this incidence of cSCC was caused by chronic inflammation which followed fixed-type sporotricosis.

Squamous cell carcinoma subsequent to scarring caused by sporotrichosis: A case report / Carcinoma de células escamosas en una cicatriz secuela de una esporotricosis: a propósito de un caso

Background: Sporotrichosis is a fungal disease caused by the Sporothrix schenckii species complex. It is usually acquired by trauma with plants. Lymphatic-cutaneous is the most common clinical manifestation. Case report: The present case describes the development of an epidermoid carcinoma as a late complication on a long evolution sporotrichosis scar. During a period of 50 years, the patient had lesions in the right hand. Sporotrichosis was diagnosed and treated with potassium iodide. Eleven years after the healing of the lesions, a squamous cell carcinoma on the scar of this mycosis was diagnosed. Conclusions: The chronic sporotrichosis injury was probably the cause of the tumor developed on the scar

Antecedentes: La esporotricosis es una enfermedad causada por el complejo de especies Sporothrix schenckii. Generalmente se adquiere por traumatismos con plantas. El compromiso linfocutáneo es la manifestación clínica más común. Caso clínico: El presente caso describe la aparición de un carcinoma epidermoide como complicación tardía en la cicatriz de una esporotricosis de larga evolución. Durante 50 años el paciente presentó lesiones en la mano derecha, se diagnosticó esporotricosis y se trató de manera tópica con yoduro de potasio. Once años después de la cicatrización de la esporotricosis, se diagnosticó un carcinoma de células escamosas en la cicatriz de esta micosis. Conclusiones: El daño en el tejido producido por la esporotricosis crónica podría ser la causa que desencadenó el proceso tumoral sobre la cicatriz

Squamous cell carcinoma subsequent to scarring caused by sporotrichosis: A case report.

BACKGROUND: Sporotrichosis is a fungal disease caused by the Sporothrix schenckii species complex. It is usually acquired by trauma with plants. Lymphatic-cutaneous is the most common clinical manifestation. CASE REPORT: The present case describes the development of an epidermoid carcinoma as a late complication on a long evolution sporotrichosis scar. During a period of 50 years, the patient had lesions in the right hand. Sporotrichosis was diagnosed and treated with potassium iodide. Eleven years after the healing of the lesions, a squamous cell carcinoma on the scar of this mycosis was diagnosed. CONCLUSIONS: The chronic sporotrichosis injury was probably the cause of the tumor developed on the scar.

Dacryocystitis due to sporothrix inoculated vis an unusual mode: Case report.

RATIONALE: Sporotrichosis is the most common subcutaneous mycosis. It is caused by the dimorphic fungus Sporothrix schenckii. Ocular sporotrichosis is uncommon and has been rarely reported. PATIENT CONCERNS: We describe a 34-year-old female who presented with a nodule increasing in size near the medial angle of the left eye. Originally, she was misdiagnosed with a dacryocyst space-occupying lesion, and the lesion was removed by surgery. DIAGNOSES: Findings of fungal structures in the histopathological examination contributed to the diagnosis of Sporothrix dacryocystitis. Further culture of conjunctival secretions and contact lens storage solution was positive for Sporothrix. INTERVENTIONS: She was treated with oral itraconazole, 200 mg by mouth twice daily. OUTCOMES: After 3 months of treatment with oral itraconazole, culture of the conjunctival secretions was negative. LESSONS: It is of paramount importance to clinically suspect mycosis, even in unusual locations or in the absence of the typical epidemiological history.