Rapidly Progressive Disseminated Sporotrichosis as the First Presentation of HIV Infection in a Patient with a Very Low CD4 Cell Count

Oliveira-Esteves, Isis Cristine Morávia Ribeiro de; Silva, Guilherme Almeida Rosa da; Eyer-Silva, Walter de Araújo; Basílio-de-Oliveira, Rodrigo; Araújo, Luciana Ferreira de; Martins, Carlos José; Neves-Motta, Rogério; Azevedo, Marcelo Costa Velho Mendes de; Signorini, Dario José Hart Pontes; Pinto, Jorge Francisco da Cunha; Moura, Lívia Machado; Laterça, Rafael Jacyntho; Pereira, Diogo Raphael Garcia de Oliveira; Lago, Isabela Vieira do; Ferry, Fernando Raphael de Almeida

doi:10.1155/2017/4713140

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…Mucosal or primary pulmonary forms are less common ( 8 ) . Some cases occur as disseminated forms with multiorgan involvement, most notably in HIV-infected persons ( 9 , 10 ).…”

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confidence: 99%

Sporotrichosis in the Highlands of Madagascar, 2013–20171

Rasamoelina¹,

Maubon²,

Raharolahy³

et al. 2019

Emerg. Infect. Dis.

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Sporotrichosis is a saprozoonotic fungal infection found mostly in tropical and subtropical areas. Few case reports in Madagascar have been published. To document sporotrichosis epidemiology in Madagascar, we conducted a cross-sectional study. During March 2013–June 2017, we recruited from select hospitals in Madagascar patients with chronic cutaneous lesions suggestive of dermatomycosis. Sporotrichosis was diagnosed for 63 (42.5%) of 148 patients. All but 1 patient came from the central highlands, where the prevalence was 0.21 cases/100,000 inhabitants. Frequency was high (64.7%) among patients <18 years of age. Sporotrichosis was diagnosed for 73.8% of patients with arm lesions, 32.3% with leg lesions, and 15.4% with lesions at other sites. Molecular identification identified 53 Sporothrix schenckii isolates. Among the 32 patients who were followed up, response to itraconazole was complete or major for 15 and minor for 17. Overall, endemicity of sporotrichosis in Madagascar was high, concentrated in the highlands.

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“…Mucosal or primary pulmonary forms are less common ( 8 ) . Some cases occur as disseminated forms with multiorgan involvement, most notably in HIV-infected persons ( 9 , 10 ).…”

mentioning

confidence: 99%

Sporotrichosis in the Highlands of Madagascar, 2013–20171

Rasamoelina¹,

Maubon²,

Raharolahy³

et al. 2019

Emerg. Infect. Dis.

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“…Four case reports were of disseminated sporotrichosis, two had a history of alcohol abuse, and two had HIV infection. The outcomes were cure in three cases and death in one [ 18 , 19 , 20 , 21 ]. The fifth report was a fatal case of PPS in an immunocompetent and non-smoker female [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

Pulmonary Sporotrichosis Caused by Sporothrix brasiliensis: A 22-Year, Single-Center, Retrospective Cohort Study

Fichman

Mota-Damasceno

Procópio-Azevedo

et al. 2022

JoF

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Pulmonary sporotrichosis is a rare condition. It can present as a primary pulmonary disease, resulting from direct Sporothrix species (spp). conidia inhalation, or as part of multifocal sporotrichosis with multiple organ involvement, mainly in immunocompromised patients. This study aimed to describe the sociodemographic and epidemiological characteristics and clinical course of patients with positive cultures for Sporothrix spp. from pulmonary specimens (sputum and/or bronchoalveolar lavage) at a reference center in an area hyperendemic for zoonotic sporotrichosis. The clinical records of these patients were reviewed. Fourteen patients were included, and Sporothrix brasiliensis was identified in all cases. Disseminated sporotrichosis was the clinical presentation in 92.9% of cases, and primary pulmonary sporotrichosis accounted for 7.1%. Comorbidities included human immunodeficiency virus infection (78.6%), alcoholism (71.4%), and chronic obstructive pulmonary disease (14.3%). Treatment with amphotericin B followed by itraconazole was the preferred regimen and was prescribed in 92.9% of cases. Sporotrichosis-related death occurred in 42.9% while 35.7% of patients were cured. In five cases there was a probable contamination from upper airway lesions. Despite the significant increase in sporotrichosis cases, pulmonary sporotrichosis remains rare. The treatment of disseminated sporotrichosis is typically difficult. Prompt diagnosis and identification of all affected organs are crucial for better prognosis.

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“…The most frequent predisposing factor of CDS was HIV-AIDS [ 3 , 21 – 24 ], usually occurring in patients in stage C of AIDS (CD4+ count <200 cells/ mm 3 ) [ 3 , 17 ]. Second, CDS can be caused by uncontrolled diabetes [ 3 , 4 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…The presence of slender hyphae under direct microscopic may be attributed to low body surface temperature in the sites of the patient's open skin lesions. So, in CDS patients, direct microscopy is an important diagnostic procedure, considering the high fungal burden in tissues of immunocompromised patients [21,55]. On the other hand, the presence of numerous yeast cells or hyphae upon conducting PLOS NEGLECTED TROPICAL DISEASES direct mycological examination and histopathology may be a red flag for a compromised immune system or a highly invasive pathogen fungus.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

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

Xia,

Zhi,

Liu

2023

PLoS Negl Trop Dis

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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.

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Rapidly Progressive Disseminated Sporotrichosis as the First Presentation of HIV Infection in a Patient with a Very Low CD4 Cell Count

Cited by 6 publications

References 18 publications

Sporotrichosis in the Highlands of Madagascar, 2013–20171

Sporotrichosis in the Highlands of Madagascar, 2013–20171

Pulmonary Sporotrichosis Caused by Sporothrix brasiliensis: A 22-Year, Single-Center, Retrospective Cohort Study

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

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