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Sporotrichosis in children is rare, and its osteoarticular form is very unusual. Disseminated forms are described mostly in immunocompromised patients. We report a case of a 5-year-old immunocompetent boy with multiple suppurated cutaneous lesions that progressed to polyarthritis of the hands and feet. Radiographic imaging demonstrated multifocal lytic lesions. Sporotrichosis was diagnosed through biopsy and culture. This article describes the radiographic appearance of a rare manifestation of this disease. In areas of high prevalence, the diagnosis of sporotrichosis should be taken into account, even in immunocompetent patients, when dactylitis with lytic lesions is present.
Sporotrichosis in children is rare, and its osteoarticular form is very unusual. Disseminated forms are described mostly in immunocompromised patients. We report a case of a 5-year-old immunocompetent boy with multiple suppurated cutaneous lesions that progressed to polyarthritis of the hands and feet. Radiographic imaging demonstrated multifocal lytic lesions. Sporotrichosis was diagnosed through biopsy and culture. This article describes the radiographic appearance of a rare manifestation of this disease. In areas of high prevalence, the diagnosis of sporotrichosis should be taken into account, even in immunocompetent patients, when dactylitis with lytic lesions is present.
Sporotrichosis is a subcutaneous fungal infection caused by Sporothrix schenckii and acquired by direct inoculation. Although the majority of cases consist of the classic lymphocutaneous presentation, the frequency of atypical and severe clinical forms of the disease has increased progressively. Systemic and disseminated cutaneous sporotrichosis constitute rare variants and such cases are generally associated with cellular immunodeficiency or debilitated states. The present paper describes the first published case of molluscum-like lesions in disseminated mucocutaneous sporotrichosis. Direct mycological examination and histopathology revealed numerous yeast cells. Keywords: Itraconazole; Mycoses; Molluscum contagiosum; Sporotrichosis Resumo: Esporotricose é uma infecção fúngica subcutânea, adquirida por inoculação direta, causada pelo Sporothrix schenckii. Embora a apresentação clássica linfocutânea represente a maioria dos casos, as formas clínicas atípicas e graves têm aumentado em ocorrência. Esporotricose sistêmica e esporotricose cutânea disseminada são variantes raras, usualmente associadas à imunodeficiência celular ou a estados debilitantes. Relatamos o primeiro caso na literatura de lesões molusco-símiles em esporotricose cutaneomucosa múltipla. Os exames micológico direto e histopatológico apresentavam-se ricos em células leveduriformes. ©2011 by Anais Brasileiros de Dermatologia ▲ The increased incidence of sporotrichosis in Brazil has led to a rise in the number of cases involving unusual sites, lesions that are morphologically different from the classic types, and to generalization and systematization of the involvement of Sporothrix schenckii. [1][2][3][4] This report describes a 52-year old male patient with a history of alcoholic hepatopathy. He reported myalgia, nighttime fever and sweating over the previous three months, as well as a weight loss of 23 kilos. Thirty days previously, he noted an erythematous papule on his left thigh that subsequently ulcerated, with rapid dissemination of lesions to the rest of his body. Dermatological examination revealed papules, nodules and ulcerations with honey-colored crusts and raised borders over his entire body ( Figure 1). Molluscum-like lesions were found on his face and cervical region, sialorrhea and ulcerations on the tonsillar pillars and nasal mucosa (Figure 2). Direct mycological examination showed numerous yeast cells. Histopathology showed chronic granulomatous der-
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