Disseminated sporotrichosis in a person with human immunodeficiency virus disease

Abstract

Introduction. Disseminated sporotrichosis is an incapacitating infection caused by the dimorphic fungus Sporothrix schenckii. Because this condition may mimic the presentation of tuberculosis, syphilis and other bacterial infections, the diagnosis may be missed or delayed. Case Presentation. We describe a case of disseminated sporotrichosis in a patient with poorly controlled human immunodeficiency virus infection. The patient was initially treated for bacterial skin infections. The differential diagnosis also included tuberculosis and syphilis. Only after appropriate specimens had been sent for microbiological and histopathological investigations was the diagnosis of disseminated sporotrichosis made and appropriate treatment started. The patient showed a good clinical response to itraconazole. Conclusion. This report highlights the importance of having a high index of suspicion of endemic mycoses when managing immunocompromised patients. The report also demonstrates that a delay in the diagnosis of sporotrichosis increases morbidity and results in unnecessary and inappropriate treatment with associated costs and adverse effects.

Invasive Fungal Diseases in Africa: A Critical Literature Review

“…Systemic cases are rarely reported. Sporotrichosis generally occurred in immunocompetent patients, but few cases in immunocompromised patients, such as one in an HIV patient was reported in South Africa [249]. Diagnosis was broadly made by culture and/or histology, and occasionally by direct examination of clinical specimen.…”

“…The common isolated fungi were Sporothrix schenckii, now identified collectively as S. schenckii sensu stricto with other closely related variants. In the recent case report from South Africa, MALDI-TOF was employed to confirm culture reports [249]. Potassium iodide was the common treatment option prior to the 20 th century.…”