Department of Dermatology, Kuala Lumpur Hospital, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
Int J Infect Dis. 2011 Oct;15(10):e727-9. doi: 10.1016/j.ijid.2011.05.005. Epub 2011 Jun 29.
Sporotrichosis is a subacute or chronic fungal infection caused by the ubiquitous fungus Sporothrix schenckii. Disseminated cutaneous sporotrichosis is an uncommon entity and is usually present in the immunosuppressed. Here, a case of disseminated cutaneous sporotrichosis in an immunocompetent patient is reported. This 70-year-old healthy woman presented with multiple painful ulcerated nodules on her face and upper and lower extremities of 6-month duration, associated with low-grade fever, night sweats, loss of appetite, and loss of weight. Histopathological examination of the skin biopsy revealed epidermal hyperplasia and granulomatous inflammation in the dermis, with budding yeast. Fungal culture identified S. schenckii. She had total resolution of the lesions after 2 weeks of intravenous amphotericin B and 8 months of oral itraconazole. All investigations for underlying immunosuppression and internal organ involvement were negative. This case reiterates that disseminated cutaneous sporotrichosis, although common in the immunosuppressed, can also be seen in immunocompetent patients.
皮肤孢子丝菌病是一种由广泛存在的申克孢子丝菌引起的亚急性或慢性真菌感染。播散性皮肤孢子丝菌病是一种罕见的疾病，通常发生在免疫抑制的患者中。在此，报告一例免疫功能正常的患者发生播散性皮肤孢子丝菌病。这位 70 岁的健康女性因面部和上下肢出现多个疼痛性溃疡性结节而就诊，病程为 6 个月，伴有低热、盗汗、食欲不振和体重减轻。皮肤活检的组织病理学检查显示表皮增生和真皮内的肉芽肿性炎症，有出芽酵母。真菌培养鉴定为申克孢子丝菌。在接受 2 周静脉注射两性霉素 B 和 8 个月的口服伊曲康唑治疗后，患者皮损完全消退。所有潜在免疫抑制和内脏器官受累的检查均为阴性。该病例再次表明，虽然播散性皮肤孢子丝菌病在免疫抑制患者中很常见，但也可发生在免疫功能正常的患者中。
