Late Diagnosis of Disseminated Sporothrix brasiliensis Infection with Bone Marrow Involvement in an HIV-Negative Patient

Abstract

Sporotrichosis is a fungal disease that causes symptoms similar to those of other infectious and non-infectious diseases, making diagnosis difficult and challenging. Here, we report a case of an HIV-negative patient presenting disseminated sporotrichosis with widespread cutaneous lesions mimicking pyoderma gangrenosum, with bone marrow infection, pancytopenia, and hemophagocytic syndrome. However, all the clinical manifestations and a bacterial coinfection delayed the request for a fungal diagnosis. Therefore, sporotrichosis should always be investigated in patients from endemic areas presenting with widespread cutaneous lesions associated with pancytopenia.

Keywords: hemophagocytic syndrome; pyoderma gangrenosum; systemic sporotrichosis.

Figure 1

Sporothrix brasiliensis morphology. (A) Culture of filamentous colonies after ten days at 25 °C on Sabouraud Dextrose Agar (SDA). (B) Optical microscopy of hyphae and typical S. brasiliensis conidia (cotton blue, ×400). (C) Culture of yeast colonies after seven days at 37 °C and 5%CO₂ on Brain Heart Infusion agar (BHI). (D) Optical microscopy of yeast colony (saline, ×400). Bar = 10 µm.