Tshisevhe Vhudzani, Skosana Lebogang, Motse Kagiso, Maphosa Tinashe, Mitton Barend
Lancet Laboratories, Rustenburg, South Africa.
Faculty of Health Sciences, Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.
Access Microbiol. 2021 Sep 21;3(9):000262. doi: 10.1099/acmi.0.000262. eCollection 2021.
Disseminated sporotrichosis is an incapacitating infection caused by the dimorphic fungus . Because this condition may mimic the presentation of tuberculosis, syphilis and other bacterial infections, the diagnosis may be missed or delayed.
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.
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.
播散性孢子丝菌病是由双相真菌引起的一种使人衰弱的感染。由于这种病症可能类似于结核病、梅毒和其他细菌感染的表现,诊断可能会被遗漏或延迟。
我们描述了一例播散性孢子丝菌病病例,患者为人类免疫缺陷病毒感染控制不佳者。该患者最初接受了细菌性皮肤感染的治疗。鉴别诊断还包括结核病和梅毒。仅在将适当的标本送去进行微生物学和组织病理学检查后,才确诊为播散性孢子丝菌病并开始进行适当治疗。患者对伊曲康唑表现出良好的临床反应。
本报告强调了在管理免疫功能低下患者时对地方性真菌病保持高度怀疑指数的重要性。该报告还表明,孢子丝菌病诊断的延迟会增加发病率,并导致不必要和不适当的治疗,伴有相关成本和不良反应。