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. 2015 May 7:12:16.
doi: 10.1186/s12981-015-0051-1. eCollection 2015.

The difficult management of disseminated Sporothrix brasiliensis in a patient with advanced AIDS

Ariane Gomes Paixão #  1 , Maria Clara Gutierrez Galhardo #  1 , Rodrigo Almeida-Paes #  1 , Estevão Portela Nunes #  1 , Marcelo Luiz Carvalho Gonçalves #  1 , Gisele Larias Chequer #  1 , Cristiane da Cruz Lamas #  1
Affiliations

The difficult management of disseminated Sporothrix brasiliensis in a patient with advanced AIDS

Ariane Gomes Paixão et al. AIDS Res Ther. .

Abstract

Sporotrichosis is an infection caused by a dimorphic fungus of the Sporothrix schenckii complex. Host immunity is an important factor in the clinical manifestations of the disease. Deeply immunocompromised individuals, especially those infected with the Human Immunodeficiency Virus (HIV) and T CD4 counts < 350 cells/ul lymphocytes, may present with the systemic form of sporotrichosis. This report describes a case of disseminated sporotrichosis caused by S. brasiliensis in a patient with advanced AIDS. The skin, lungs, bones and central nervous system were affected. Medical treatment involved the administration of amphotericin B, terbinafine, itraconazole and posaconazole. Posaconazole was associated with the best clinical response and clearing of the fungus from the central nervous system.

Keywords: AIDS; Amphotericin B; Posaconazole; Sporotrichosis.

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Figures

Figure 1
Figure 1
Photographs on admission to IPEC/FIOCRUZ on June, 2012. Polymorphic Sporotrichosis Lesions.
Figure 2
Figure 2
Plain radiographs of hands (A) and lower limbs (B) showing osteolytic lesions (on June 2012, admission to IPEC).
Figure 3
Figure 3
Evolution of the skin lesions after treatment. Evolution of the skin lesions.
Figure 4
Figure 4
Brain CT Scan on October 2013 showing exudative hydrocephalus.
Figure 5
Figure 5
Brain CT scan on January 2014, showing intraventricular shunt in place and hydrocephalus.
Figure 6
Figure 6
Abdomen CT Scan, January 2014, showing infrahepatic fluid collection (CSF).
See this image and copyright information in PMC

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