Abstract
We present a case of disseminated cutaneous sporotrichosis in a 72-year-old male patient who has multiple ulcerated painless nodules over the left side of his chest and on his upper and lower left limbs for three years. He was initially diagnosed to have nodular vasculitis based on early repeated biopsies. Despite the patient’s good compliance with his prednisolone medication, no significant clinical improvement was observed. Another biopsy, which was arranged after two years of treatment for nodular vasculitis, supported the diagnosis of sporotrichosis. Itraconazole was initiated, and all the lesions showed a remarkable response toward the treatment. The delay in finding the correct diagnosis unnecessarily exposed the patient to the side effects of steroid and caused the disease to worsen. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 191-195
Highlights
Sporotrichosis is a chronic granulomatous infection caused by dimorphic fungus Sporothrixschenckii
Sporotrichosis is a rare infection in certain countries but not in tropical and subtropical countries, such asMexico, Central America, South America and Africa, where the highest numbers of cases have been reported[6].With the emergence of a vast variety of diseases, medical practitioners should have a high index of suspicion towards certain diseasesthat are common in their locality
Nodular vasculitis is an uncommon inflammatory disorder characterized by erythematous, warm, tender subcutaneous nodules classically present on the calf,which eventually ulcerate
Summary
Sporotrichosis is a chronic granulomatous infection caused by dimorphic fungus Sporothrixschenckii. In February 2019, he moved to his hometown where he came to see us in our dermatology clinic.His prednisolone was continued.After a few months of follow up, the lesions over his upper and lower left limbs worsened with purulent discharge (Figure 4). Another skin biopsy was arranged in our clinic. All the radiographs were clear wherein no lytic lesions or erosions of articular surfaces were seen.His liver function test showed normal results He was diagnosed to have disseminated cutaneous sporotrichosis, and treatment with 200mg itraconazole capsule twice daily was commenced. The patient was intended to continue with itraconazole syrup for six months after all of the lesions were fully resolved
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