Efficacy of acute phase and maintenance therapy with itraconazole in an AIDS patient with sporotrichosis

Bolao, Ferrán; Podzamczer, Daniel; Ventin, Manuel; Gudiol, Francesc

doi:10.1007/bf01971316

Cited by 36 publications

(13 citation statements)

References 14 publications

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“…Three patients who reported. However, S. schenckii fungemia is rare, and the present case represents the second report concerning an HIVreceived itraconazole had no documented relapse after 11 -12 months [2,15,17], and a fourth patient was free of disease infected patient. Fifteen of the 16 reported cases involved men (mean age, 38.8 years; range, 22 -71 years).…”

Section: Literature Review and Discussionmentioning

confidence: 95%

“…All patients presented with diffuse ulcerative skin lesions similar to those in the present case. Involve- [15]. Therapeutic failures have been described in association with SSKI [9], fluconazole [14], and ketoconazole [15].…”

Section: Literature Review and Discussionmentioning

confidence: 99%

“…Involve- [15]. Therapeutic failures have been described in association with SSKI [9], fluconazole [14], and ketoconazole [15]. ment of the CNS [2,13,14,18], eye [7,10], joints [1,6,9,10], spleen [1], and bone marrow [10] have been previously…”

Section: Literature Review and Discussionmentioning

confidence: 99%

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Disseminated Sporotrichosis andSporothrix schenckiiFungemia as the Initial Presentation of Human Immunodeficiency Virus Infection

1998

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Infection with Sporothrix schenckii causes a localized lymphocutaneous disease in the immunocompetent host, while it frequently results in disseminated disease in the immunocompromised patient. There are a growing number of reports of S. schenckii infection in the human immunodeficiency virus (HIV)-infected population, where the disease usually starts as a localized cutaneous lesion and subsequently disseminates. The optimal treatment of systemic sporotrichosis in HIVpositive patients is as yet unknown. This article presents a case report of disseminated sporotrichosis in an HIV-infected patient, a review of the literature, and discussion of treatment options for HIVinfected patients.Sporotrichosis is caused by Sporothrix schenckii, a dimormixed superficial and perivascular inflammation compatible with an eczematous process. He responded to therapy with phic fungus with a global distribution. It is found in soil [1] and plant material such as sphagnum moss [2]. Sporotrichosis high-dose prednisone and cephalexin, but the lesions subsequently worsened. commonly presents as limited lymphocutaneous lesions but in rare cases is disseminated [3]. The lymphocutaneous form reThree months after presentation he was hospitalized with progressive disease involving an eschar on the distal thumb and sults from cutaneous inoculation and subsequent lymphatic spread. Disseminated disease may be acquired through cutaprominent woody edema of the wrist. The patient underwent debridement of the right thumb, received ceftriaxone, and was neous inoculation, inhalation, or (rarely) ingestion [3,4], and it usually results in diffuse cutaneous lesions with involvement referred to our institution for further evaluation.On presentation a biopsy of a wrist lesion was performed, of one or more additional organ systems.and high-dose prednisone therapy was given for presumed pyoDisseminated disease most freqently occurs in immunocomderma gangrenosum. One week later, there was worsening of promised individuals such as alcoholics, diabetics [5], patients the skin lesions over the forearm (figure 1) and further ulcerwith chronic obstructive pulmonary disease [5] or a hematoation and necrosis of the right thumb, with lymphatic streaking logic malignancy, solid organ or bone marrow transplant recipi-(figure 2). Periodic acid -Schiff staining and Grocott-Gomori ents, those receiving corticosteroid therapy, and those infected methenamine -silver nitrate staining of the skin biopsy speciwith HIV [5 -7]. In this report we describe a case of disseminmens revealed numerous cigar-shaped spores consistent with ated sporotrichosis and S. schenckii fungemia occurring as the S. schenckii. initial presentation of AIDS.The patient was hospitalized and received amphotericin B (0.5 mg/[kgrd]) for disseminated sporotrichosis and ticarcillin/ Case Report clavulanic acid for presumed secondary bacterial infection. He A 47-year-old male presented to our facility for evaluation subsequently tested positive for HIV and had a CD4 cell count of skin lesions. Four months ...

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Section: Literature Review and Discussionmentioning

confidence: 95%

Section: Literature Review and Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Disseminated Sporotrichosis andSporothrix schenckiiFungemia as the Initial Presentation of Human Immunodeficiency Virus Infection

1998

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“…Itraconazole is reported to be suitable for treatment of HIV-infected patients with sporotrichosis [10]. Sporotrichosis in our patient with disseminated malignant lymphoma also responded well to itraconazole, suggesting that itraconazole is effective against sporotrichosis in immunocompromised patients.…”

Section: Introductionmentioning

confidence: 71%

Solitary Sporotrichosis Lasting for 10 Years

Shiraishi¹,

Gomi²,

Kawada³

et al. 1999

Dermatology

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“…[3][4][5][6][7][8][9][10] This may be due to infrequent occurrence of autoinoculation or difficulties in diagnosis, particularly in high prevalence Disseminated Sporothix schenckii in a patient with AIDS e75 resource-poor regions. Skin lesions are the commonest manifestation but pneumonia, arthritis, endophthalmitis and meningitis have also been described.…”

Section: Discussionmentioning

confidence: 99%