Disseminated Sporotrichosis with Osteolytic Bone Involvement

Excerpt

An 89-year-old Laotian immigrant with a past medical history of diet-controlled diabetes mellitus presented with a 4-month history of fevers and skin lesions that persisted despite two courses of oral antibiotics. He also complained of dysphagia and odynophagia. He denied recent travel or gardening, but reported exposure to outdoor-dwelling cats. Physical examination revealed abscesses in various stages of healing involving the chin, trunk and elbows, but were most pronounced on the fingers, hands (Fig. 1) and feet. X-rays of both lower extremities (performed to assess for osteomyelitis) revealed multiple cortical tibial lucencies consistent with disseminated mycosis (Fig. 2). Wound swab and bone cultures grew Sporothrix schenckii. Biopsies of the left false vocal cord showed granulomatous inflammation consistent with sporotrichosis. HIV testing returned negative results.

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