Cutaneous disseminated sporotrichosis: a case report and literature review

Abstract

Abstract:

Objective Investigate the etiology, clinical characteristics, diagnosis and differential diagnosis of cutaneous disseminated sporotrichosis to improve the understanding of the disease and to avoid misdiagnosis and mistreatment. Methods The clinical symptoms, histopathology, and fungal culture results of a patient with cutaneous disseminated sporotrichosis were analyzed and literatures were reviewed. Results The patient suffered hoarseness at the very beginning. Three months later several nodules were distributed on her body. Nodules gradually increased and ulcerated with pus and blood. Histopathological examination of pharyngeal portion showed papillomatosis and multinucleated giant cells. But acid-fast stain test was negative. Fungal examination with microscope and culture from the pus of lesions were negative. Histopathological examination of skin lesions showed infective granulomas. Fungal culture of tissue was positive. Cutaneous disseminated sporotrichosis was confirmed. Conclusion In immunocompetent population the incidence of disseminated sporotrichosis was low, resulting misdiagnosis and mistreatment. The tissue culture was superior to the pus culture for the diagnosis of sporotrichosis.

Key words: sporotrichosis, cutaneous disseminated, hoarseness

CLC Number:

R519.8

LIU Wen, SHAO Li-fang, ZHAO Qing-li, ZHAO Guang. Cutaneous disseminated sporotrichosis: a case report and literature review[J]. Chinese Journal of Mycology, 2018, 13(1): 30-33.

References

[1] 赵辨.中国临床皮肤病学[M].江苏:江苏科学技术出版社,2010:579-581.
[2] Oliveira MM, Santos C, Sampaio P, et al. Development and optimization of a new MALDI-TOF protocol for identification of the Sporothrix species complex[J]. Res Microbiol, 2015,166(2):102-110.
[3] 景东云,王学军,彭琳琳,等.临床分离99株孢子丝菌病原体的分子和表型鉴定[J].中国皮肤性病学杂志,2015,29(3):231-234.
[4] da Silva RF, Bonfitto M, da Silva Junior FIM, et al. Sporotrichosis in a liver transplant patients:a case report and literature review[J]. Medical Mycology Case Reports, 2017,17(C):25-27.
[5] Bahr NC, Janssen K, Billings J, et al. Respiratory failure due to possible donor-derived Sporothrix schenckii infection in a lung transplant recipient[J]. Case Rep Infect Dis, 2015,2015:925718.
[6] 刘晓.208例孢子丝菌病临床分析[J].吉林医学.2011,(1):40-41.
[7] 梅向林,夏建新,王敬医,等.孢子丝菌病100例临床及病理分析[J].中国真菌学杂志.2011,(4):203-206.
[8] Lyra MR, Nascimento ML,Varon AG, et al. Immune reconstitution inflammatory syndrome in HIV and sporotrichosisco infection:report of two cases and review of the literature[J]. Rev Soc Bras Med Trop, 2014, 47(6):806-809.
[9] 李丽,王劲风,姜兰香,等.皮肤播散型孢子丝菌病1例[J].中国皮肤性病学杂志.2013,(3):292-293.
[10] 吕莎,李福秋,金菊花,等.1例皮肤播散型孢子丝菌病的分离株的基因鉴定[J]. 中国真菌学杂志,2013, 8(1):35-36.
[11] 苏畅,李珊山,田亚平,等.皮肤播散型孢子丝菌病1例[J].中国皮肤性病学杂志.2007,(8):498-499.
[12] 何勤,凌淑清,李冠群,等. 特比萘芬治疗皮肤播散型孢子丝菌病一例[J]. 临床皮肤科杂志, 1998, 2(5):318-319.
[13] 夏建新,王延龙,王平凡,等.皮肤播散型孢子丝菌病一例[J]. 临床皮肤科杂志, 2006, 35(11):729-730.
[14] Fernandes GF, dos Santos PO, Rodrigues AM, et al. Characterization of virulence profile, protein secretion and immunogenicity of different Sporothrix schenckii sensu stricto isolates compared with S. globosa and S. brasiliensis species[J]. Virulence, 2013, 4(3):241-249.
[15] 孔祥明,林俊萍,王雅坤,等.申克孢子丝菌基因差异、致病力与孢子丝菌病临床型别的关系[J].中华皮肤科杂志.2005,(6):338-341.
[16] Nascimento RC, Espíndola NM,Castro RA, et al. Passive immunization with monoclonal antibody against a 70-kDa putative adhesin of Sporothrix schenckii induces protection in murine sporotrichosis[J]. Eur J Immunol, 2008, 38(11):3080-3089.
[17] Franco Dde L, Nascimento RC, Ferreira KS, et al. Antibodies against Sporothrix schenckii enhance TNF-α production and killing by macrophages[J]. Scand J Immunol, 2012, 75(2):142-146.
[18] de Almeida JR, Santiago KL, Kaihami GH, et al. The efficacy of humanized antibody against the Sporothrix antigen, gp70, in promoting phagocytosis and reducing disease burden[J]. Front Microbiol. 2017, 8:345.
[19] 张晓冬,曹荣臻.孢子丝菌病患者浓汁及新鲜组织培养结果对比研究[J]. 北华大学学报, 2014, 15(6):769-771.