Case Report. Bilateral sporotrichosis.
We describe a rare case of sporotrichosis, clinically exuberant, with bilateral distribution.
Biopsy↗
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Laboratory-acquired sporotrichosis.
A case of laboratory-acquired sporotrichosis was diagnosed by immunofluorescence and by culture. The patient was then cured by treatment with oral potassium iodide. The need to handle cultures of Sporothrix schenckii with due caution is stressed.
Adult↗
Case report of synovial sporotrichosis involving both wrists.
A case of synovial sporotrichosis involving both wrists in a 46-year-old unemployed carpenter is described. Clinical, laboratory diagnostic and therapeutic aspects are discussed.
Humans↗
Canine sporotrichosis in Rio de Janeiro, Brazil: clinical presentation, laboratory diagnosis and therapeutic response in 44 cases (1998-2003).
A sporotichosis epidemic involving forty-four dogs in the Metropolitan area of Rio de Janeiro is described. Solitary skin lesions were noted in 18 dogs (40.9%), 2-4 such lesions were observed in 17 animals (38.6%), and nine (20.5%) animals had five or more lesions. Twenty-five (56.8%) animals had single ulcerated skin lesions on the nose and nine (20.5%) showed nasal mucosal involvement (three of which also has a skin lesion). Respiratory symptoms were observed in 17 (38.6%) dogs and were found to be the most common extracutaneous signs of infection. Anemia, leukocytosis with neutrophilia, hypoalbuminemia and hyperglobulinemia were the most frequent hematological abnormalities. Histopathological analysis of skin biopsies in most cases revealed granulomatous reactions characterized by histiocytic hyperplasia and neutrophil infiltration. Yeast-like cells were observed in seven (16.7%) of 42 dogs examined histologically. During the study, eight (18.2%) animals were lost to follow-up and three (6.8%) were submitted to euthanasia. Of the remaining 33 dogs, five (15.2%) presented spontaneous regression of the lesions, 26 (78.8%) were cured after treatment, and two (6%) continue to be treated. The present cases indicate that many dogs with sporotrichosis respond well to treatment and in a few dogs, the disease may be self-limiting.
Anemia↗
Bursal sporotrichosis: case report and review.
We describe a patient whose prepatellar bursa was infected with Sporothrix schenckii. The infection persisted despite itraconazole therapy and cure was achieved only after surgical excision of the bursa. A review of treatments for bursal sporotrichosis is presented.
Bursa, Synovial↗
Disseminated sporotrichosis associated with treatment with immunosuppressants and tumor necrosis factor-alpha antagonists.
We report a case of disseminated sporotrichosis in a 49-year-old man who was treated with multiple immunosuppressants, including tumor necrosis factor (TNF)-alpha antagonists (etanercept and infliximab), for presumed inflammation arthritis. This case illustrates the potential for infectious complications related to the use of cytotoxic immunosuppressants and anticytokine agents, such as TNF-alpha antagonists.
Antibodies, Monoclonal↗
Sporotrichosis: recurrent cutaneous, articular, and central nervous system infection in a renal transplant recipient.
A case of recurrent, disseminated sporotrichosis in a renal transplant recipient is reported in which two joints, the skin, and the central nervous system were involved. The disease recurred both eight months and three years after the initial treatment with amphotericin B. The second course of therapy with amphotericin B required systemic and intraarticular administration of the drug. The third course of therapy included systemic and intrathecal administration. The function of the cadaveric transplanted kidney was maintained throughout the first recurrence of disease by careful reduction of immunosuppressive therapy and attention to the level of antifungal therapy. The kidney could not be salvaged after the second recurrence because of continued amphotericin B nephrotoxicity; however, the patient was cured of his infection. Sporothrix (Sporotrichum) schenckii may be a difficult organism to eradicate in chronically immunosuppressed patients, but the disease it causes may be successfully treated with aggressive systemic therapy.
Amphotericin B↗
Case report. Disseminated sporotrichosis presenting as sarcoidosis: electron microscopic and immunologic studies.
A 50-year-old black man with constitutional symptoms, cutaneous nodules, and bilateral hilar adenopathy was found to have non-caseating granulomata on bronchial biopsy. He was treated with corticosteroids for sarcoidosis. Within five months he was found to have disseminated sporotrichosis. Electron microscopy revealed mycelial forms of S. schenckii in superficial lesions and yeast forms from deep tissue sites: no novel forms were seen. Blood mononuclear cell studies revealed hyperactive suppressor cells with respect to non-specific T cell targets and the antigen specific target. Examination of the initial biopsy material after digestion with diastase before PAS staining revealed budding yeast consistent with S. schenckii. This case emphasizes the need for careful histopathologic examination of clinical material before a diagnosis of sarcoidosis is made, and reveals an immunologic abnormality which may account for the patient's anergic state and susceptibility to S. schenckii infection.
Bronchial Diseases↗
A familial occurrence of sporotrichosis.
A grandfather and granddaughter suffering from sporotrichosis were reported. It is thought that they might have been infected from the same source of Sporothrix schenckii (S. schenckii).
Aged↗
Cutaneous sporotrichosis and distant autoinoculation.
A 56-year-old woman suffering from cutaneous sporotrichosis on the right cheek and right knee is described. The sporotrichotic nodule of the knee was thought to have been caused by distant autoinoculation.
Dermatomycoses↗
A case of cutaneous disseminated sporotrichosis.
We described a case of cutaneous disseminated sporotrichosis. The condition was diagnosed based on isolation and identification of Sporothrix schenckii from the lesions. The patient was otherwise normal, including a negative HIV test. The blood culture did not grow S. schenckii. However, spores were detected in the biopsy histological sections and stained positively with PAS staining and ConA and LCA lectin histochemistry.
Abdomen↗
Localized cutaneous sporotrichosis.
Localized sporotrichosis can present a difficult diagnostic problem. It mimics many other skin diseases, some of which are far more common. Often the skin biopsy is not helpful. The disease tends to be chronic, requiring specific therapy with potassium iodide.
Administration, Oral↗
Sporotrichosis in Nepal.
The first case of sporotrichosis from Nepal is reported in a 25-year-old man from a village about 60 km east of Kathmandu. He never travelled outside of Nepal before and had acquired the lymphocutaneous form of the disease after an accidental injury to the right foot while cutting wood. The diagnosis of the case was made by culturing Sporothrix schenckii from the lesions, proving the dimorphic character of the fungus in vitro, its pathogenicity in mice, and its serology. Oral potassium iodide therapy resulted in complete cure.
Adult↗
Effect of immunization and potassium iodide on polymorphonuclear leukocyte chemiluminescence in experimental murine sporotrichosis.
This study was undertaken to examine the effects of immunization with Sporothrix schenckii and oral potassium iodide (KJ) administration on the chemiluminescence (CL) response of mouse polymorphonuclear leukocytes (PMNs) in experimental murine sporotrichosis. When N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP) particles were used as foreign bodies to be phagocytosed, the time to the peak CL response of the PMNs in an immunized group was shortened in comparison with a non-immunized control group, and the CL intensity was found to be prolonged. Whereas administration of KJ resulted in a reduction of the CL intensity in non-immunized mice, in immunized mice it caused a rise in CL intensity. When the foreign bodies used as targets for phagocytosis were Sp. schenckii, changes similar to the above occurred, but CL production was reduced.
Animals↗
Ultrastructure of asteroid bodies in sporotrichosis.
Ultrathin sections were prepared from a paraffin-embedded tissue specimen which had been obtained from a sporotrichosis patient and in which large numbers of asteroid bodies had been observed. Electronmicroscopic examination of the ultrastructure of the asteroid bodies revealed a central fungal cell with peripheral rays. These cells were almost structurally identical with fungal elements found elsewhere than in asteroid bodies; and in the rays, electron-dense granular substance was arranged in layers marked by fissures and material resembling remnants of destroyed host cells. The outermost layer was formed of a granular substance of rather low electron density, surrounded by adherent cell membrane fragments. These findings suggest that an asteroid body might be composed of crystalline products of disintegrated host cells deposited around a fungal cell.
Cell Wall↗
Symmetrical deforming cutaneous sporotrichosis of long duration.
A symmetrical deforming cutaneous sporotrichosis with verrucous lesions on both hands and of long clinical duration is reported. The difficulties in making an etiological diagnosis are considered.
Hand Deformities, Acquired↗
Hyperthermic treatment of sporotrichosis: experimental use of infrared and far infrared rays.
We used pocket warmers and infrared and far infrared rays to treat 14 cases of sporotrichosis, 7 in children and 7 in adults. There were 9 cases of the fixed cutaneous type and 5 of the lymphocutaneous type; 6 were located on the face and 8 on the limbs. Four cases were treated with pocket warmers, 5 with infrared rays, and 5 with far infrared rays. All lesions treated with pocket warmers were facial lesions in children; infrared and far infrared ray treatments were used in 3 children and 7 adults, 2 on facial lesions and 8 on lesions on the extremities. In treatments with infrared and far infrared rays, the amount of heat was greater than with the pocket warmers, and one 15-min treatment daily was sufficient to yield satisfactory results, but this method is difficult to use on children and on the face, and 40-min treatments two or three times a week proved unsatisfactory. Infrared and far infrared ray treatments allow the length of a single treatment to be reduced by three-quarters, in comparison with one pocket warmer treatment.
Adult↗
Ocular and concomitant cutaneous sporotrichosis.
We report here the case of a 12-year-old girl with concomitant cutaneous and ocular sporotrichosis. Sporothrix schenckii was isolated from skin lesions and aqueous humour. The difficulty in the diagnosis and treatment of this form of mycosis is discussed and the data are compared with those published in the few reports available in the literature.
Amphotericin B↗