Microbiology, The Royal London Hospital, London, UK.
Histopathology, The Royal London Hospital, London, UK.
BMJ Case Rep. 2022 May 24;15(5):e248418. doi: 10.1136/bcr-2021-248418.
A veterinarian presented with multiple erythematous tender nodules over his right hand and arm. One month prior to the appearance of the lesions, he had treated a cat imported from Brazil who had ulcerated pustular cutaneous lesions. Despite antibiotic treatment there had been no improvement in his symptoms.Biopsies from the patient were sent for histology, bacterial and fungal culture. Periodic acid-Schiff (PAS) stains showed a PAS positive oval yeast-like micro-organism with surrounding necrosis. Fungal cultures resembling species grew after 18 days with typical appearances seen on direct microscopy; this was confirmed as on 18S PCR. The patient was treated with oral itraconazole.This is a unique case of cutaneous acquired from an infected imported cat. is a rare pathogen in the UK. This case has clinical relevance due to its unusual aetiology and in raising awareness of rarer infections associated with importation of pets and global travel. Clinicians should be aware of sporotrichosis as a differential diagnosis for cutaneous and extracutaneous infection in patients with a high risk of exposure, as well as the use of appropriate diagnostic tests.
一位兽医出现了多个红斑性压痛结节在他的右手和手臂。一个月前,他治疗了一只从巴西进口的猫,这只猫有溃疡性脓疱性皮肤病变。尽管进行了抗生素治疗,他的症状仍没有改善。从患者身上采集的活检标本被送去进行组织学、细菌和真菌培养。过碘酸希夫(PAS)染色显示 PAS 阳性的椭圆形酵母样微生物,周围有坏死。18 天后,类似 种的真菌培养物生长,直接镜检可见典型外观;这通过 18S PCR 被确认为 。患者接受了口服伊曲康唑治疗。这是一例从感染的进口猫身上获得的皮肤 的独特病例。在英国, 是一种罕见的病原体。由于其不寻常的病因以及与宠物进口和全球旅行相关的罕见感染的认识提高,该病例具有临床相关性。对于有高暴露风险的皮肤和皮肤外感染患者,临床医生应注意孢子丝菌病作为鉴别诊断,以及使用适当的诊断测试。