Primary Conjunctival Sporotrichosis

Schubach, Armando de Oliveira; Barros, Mônica Bastos de Lima; Schubach, Tânia Maria Pacheco; Francesconi-do-Valle, Antônio Carlos; Gutierrez-Galhardo, Maria Clara; Sued, Márcio; Salgueiro, Mariza de Matos; Fialho-Monteiro, Paulo Cezar; Reis, Rodrigo S.; Marzochi, Keyla Belízia Feldman; Wanke, Bodo; Conceição-Silva, Fátima

doi:10.1097/01.ico.0000151504.26695.3e

Cited by 42 publications

(17 citation statements)

References 24 publications

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“…In granulomatous conjunctivitis, grouped yellowish nodules are observed, with a smooth, shiny surface involving the tarsal and/or bulbar conjunctiva, associated with conjunctival hyperemia and/or purulent exudate. 7 Initially, the nodule caused by granulomatous conjunctivitis is often confused with hordeolum and chalazion, and ocular sporotrichosis is an important differential diagnosis in lesions not responding to standard treatment. POS occurs when the patient has granulomatous conjunctivitis and pre-auricular or submandibular ipsilateral lymphadenopathy, as observed in patients 2 and 3.…”

Section: Discussionmentioning

confidence: 99%

Ocular sporotrichosis: A frequently misdiagnosed cause of granulomatous conjunctivitis in epidemic areas

Yamagata

Rudolph

Nobre

et al. 2017

American Journal of Ophthalmology Case Reports

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PurposeSporotrichosis is a subcutaneous mycosis caused by Sporothrix sp., a dimorphic fungus. Although the cutaneous form is the most frequent form, the ocular presentation has been increasingly diagnosed in epidemic areas. We describe three cases of ocular sporotrichosis with the involvement of the ocular adnexa due to autoinoculation without trauma with successful antifungal treatment.ObservationsPatient 1: A 68-year-old woman presented with granulomatous conjunctivitis of the right eye with an ulcerated nodule on the right temporal region for 5 months. Patient 2: A 46-year-old woman with conjunctival hyperemia of the left eye with associated periorbital edema and erythema for the past 4 months was referred to the Dermatology Department due to an ulcerated nodule on the left malar region. Patient 3: A 14-year-old boy presented to the emergency department with inferior palpebral edema with a 5-day evolution. Specimens were obtained from the lesions of the three patients, and the cultures were positive for Sporothrix sp. The three cases were diagnosed as ocular sporotrichosis and were successfully treated with itraconazole (200–400 mg/d). Two of the three patients developed sequelae such as conjunctival fibrosis and symblepharon.Conclusions and importanceWe emphasize the importance of the ophthalmologist being familiar with the diagnosis and management of this rare and frequently misdiagnosed form of sporotrichosis.

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Section: Discussionmentioning

confidence: 99%

Ocular sporotrichosis: A frequently misdiagnosed cause of granulomatous conjunctivitis in epidemic areas

Yamagata

Rudolph

Nobre

et al. 2017

American Journal of Ophthalmology Case Reports

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“…In children clinical profile is almost similar but facial involvement is more frequent accounting for 40–60% or as high 97% in some series [ 13 , 17 , 27 ]. It is also interesting to know that Brazilian isolates present a distinct clinical picture with immune manifestations (erythema multiforme), disseminated cutaneous lesions, and atypical forms [ 28 , 29 ]. Such a varied disease spectrum has been attributed to factors like the mode of inoculation, the size and depth of the traumatic inoculum, the host immunity (fixed cutaneous sporotrichosis is considered to occur in patients with certain immunity against the fungus), and the virulence and thermotolerance of the fungus (the strains growing best at 35°C purportedly cause fixed cutaneous sporotrichosis and strains that grow both at 35°C and 37°C have been implicated for lymphocutaneous and extracutaneous disease) [ 12 , 15 , 30 , 31 ].…”

Section: Clinical Presentationsmentioning

confidence: 99%

Sporotrichosis: An Overview and Therapeutic Options

Mahajan¹

2014

Dermatology Research and Practice

177

194

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Sporotrichosis is a chronic granulomatous mycotic infection caused by Sporothrix schenckii, a common saprophyte of soil, decaying wood, hay, and sphagnum moss, that is endemic in tropical/subtropical areas. The recent phylogenetic studies have delineated the geographic distribution of multiple distinct Sporothrix species causing sporotrichosis. It characteristically involves the skin and subcutaneous tissue following traumatic inoculation of the pathogen. After a variable incubation period, progressively enlarging papulo-nodule at the inoculation site develops that may ulcerate (fixed cutaneous sporotrichosis) or multiple nodules appear proximally along lymphatics (lymphocutaneous sporotrichosis). Osteoarticular sporotrichosis or primary pulmonary sporotrichosis are rare and occur from direct inoculation or inhalation of conidia, respectively. Disseminated cutaneous sporotrichosis or involvement of multiple visceral organs, particularly the central nervous system, occurs most commonly in persons with immunosuppression. Saturated solution of potassium iodide remains a first line treatment choice for uncomplicated cutaneous sporotrichosis in resource poor countries but itraconazole is currently used/recommended for the treatment of all forms of sporotrichosis. Terbinafine has been observed to be effective in the treatment of cutaneous sporotrichosis. Amphotericin B is used initially for the treatment of severe, systemic disease, during pregnancy and in immunosuppressed patients until recovery, then followed by itraconazole for the rest of the therapy.

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“…1,2 It is subdivided into cutaneous (lymphatic, localized and disseminated) and extracutaneous forms. 2,3 The disseminated cutaneous form is rare, asymptomatic, more frequent among the immunosuppressed. 4,5 A case of disseminated cutaneous sporotrichosis is here described in a woman at the expected age, with history of household contact with cats that eventually scratched her face.…”

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confidence: 99%

Disseminated cutaneous sporotrichosis associated with ocular lesion in an immunocompetent patient

Medeiros

Landeiro

Diniz

et al. 2016

An. Bras. Dermatol.

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A 59-year-old female patient, previously healthy, immunocompetent, presented left bulbar conjunctiva lesions and nodular-ulcerated lesions on the arms and cervical region, besides left cervical and retroauricular lymphadenopathy. She had previous contact with domestic cats that excoriated her face. The diagnosis was conclusive of disseminated sporotrichosis through clinical and epidemiological history and cultures of skin and ocular secretions. It evolved with good response to oral antifungal therapy.

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Primary Conjunctival Sporotrichosis

Abstract: Sporotrichosis is presently occurring as an emerging zoonosis in Rio de Janeiro, and some unusual clinical forms have been diagnosed in humans. The cases reported here suggest atraumatic exposure to cats infected by S. schenckii.

Cited by 42 publications

References 24 publications

Ocular sporotrichosis: A frequently misdiagnosed cause of granulomatous conjunctivitis in epidemic areas

Ocular sporotrichosis: A frequently misdiagnosed cause of granulomatous conjunctivitis in epidemic areas

Sporotrichosis: An Overview and Therapeutic Options

Disseminated cutaneous sporotrichosis associated with ocular lesion in an immunocompetent patient

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