Volume 5 • Issue 10 • 1000352
Open Access Case Report
J AIDS Clin Res
ISSN: 2155-6113 JAR an open access journal
Esteves et al., J AIDS Clin Res 2014, 5:10
http://dx.doi.org/10.4172/2155-6113.1000352 AIDS & Clinical
Research
Disseminated Cutaneous Sporotrichosis in an Immunosuppressed Patient
Paola Machado Gomes Esteves
1
, Beatriz Moritz Trope
1
, Marcella Gramigna Magalhaes Barbalho
1
, Tyomi Akiti
2
and Marcia Ramos-e-Silva
1
*
1
Sector of Dermatology and Post-Graduation Course – University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
2
Mycologist, Mycology Laboratory, University Hospital and School of Medicine, Federal University of Rio de Janeiro
*Corresponding author: Marcia Ramos-e-Silva, Sector of Dermatology and
Post-Graduation Course – University Hospital and School of Medicine, Federal
University of Rio de Janeiro, Rua Dona Mariana 143 / C-32, Botafogo 22280-
020, Rio de Janeiro Brazil, Tel: 55-21-999852696; Fax: 55-21-22864632; E-mail:
ramos.e.silva@dermato.med.br
Received June 20, 2014; Accepted September 20, 2014; Published September
29, 2014
Citation: Esteves PMG, Trope BM, Barbalho MGM, Akiti T, Ramos-e-Silva M (2014)
Disseminated Cutaneous Sporotrichosis in an Immunosuppressed Patient. J AIDS
Clin Res 5: 352. doi:10.4172/2155-6113.1000352
Copyright: © 2014 Esteves PMG, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Keywords: Sporotrichosis; Sporothrix; Immunosuppression
Introduction
e case presented exemplifies disseminated cutaneous
sporotrichosis, affecting an immunocompromised individual.
is disease is a subacute or chronic infection caused by the
Sporothrix complex [1,2]. It is a primary cutaneous infection with
different clinical forms: disseminated by lymphatic vessels, the most
frequent, localized cutaneous, disseminated cutaneous and rarely
extracutaneous form. e cutaneous disseminated and systemic forms
of sporotrichosis are considered very severe opportunistic infections
and usually occur in immunodepressed patients [2]. It is endemic in
Rio de Janeiro, Brazil, where transmitted mainly by traumatic skin
inoculation, as can occur with owners and professionals leading with
cats [3]. Several cases have been reported to be associated with HIV
[1,4].
Case Report
A 30-years-old black man presented ulcero-crusted disseminated
cutaneous lesions associated to dysphagia for around three months. He
referred loss of weight, odynophagia, productive cough and aſternoon
fever for the past six months. When asked, the patient stated he did not
have any contact with animals, including cats, or worked with plants.
On examination, he showed ulcero-crusted round lesions. ey
were individualized, non-confluent affecting the face (Figure 1),
upper and lower limbs, antero-posterior trunk (Figure 2) and nasal
and oral mucosa. (Figure 3) e main differential diagnoses were:
systemic mycosis, cutaneous tuberculosis, cytomegalovirosis, atypical
Abstract
The authors present a case of sporotrichosis, a systemic fungal infection frequently observed in Rio de Janeiro,
where nowadays most cases are transmitted by cats. The disseminated cutaneous form, as seen in our patient, is rare
and shows multiple cutaneous lesions. This form is almost always associated with immunosuppression, as the case
we present, who was diagnosed as HIV+ during the diagnostic evaluation of the mycosis.
Figure 1: Lesions on the left side of the face.
Figure 2: Lesions on the right side of the face.
Figure 3: Lesions on the left arm and trunk.