Disseminated sporotrichosis following iatrogenic immunosuppression for suspected pyoderma gangrenosum

Marissa White, La'Tonzia T. Adams, Casey Phan, Gulsun Erdag, Marissa Totten, Richard Lee, Xuelian Lu, Seema Mehta, Lloyd S. Miller, Sean X. Zhang

Research output: Contribution to journalReview article

Abstract

Sporotrichosis is an infection caused by the dimorphic fungus Sporothrix schenckii and related species that often arises from traumatic inoculation of inhabited soil and organic debris into skin. The infection is usually limited to the skin in immunocompetent patients, usually as lymphocutaneous sporotrichosis. Accurate diagnosis rests on clinical data and culture, and might be facilitated by biopsy identification of suppurative and granulomatous inflammation with fungal elements. In this Grand Round, we present a dramatic case of cutaneous sporotrichosis initially presented with an atypical large ulcer without associated lymphocutaneous spread, clinically mimicking pyoderma gangrenosum, and subsequently progressed to disseminated sporotrichosis in the setting of iatrogenic immunosuppression. We further review the clinical features, risk factors, and treatment of these disseminated sporotrichosis cases, and discuss the need for improved awareness of this fungus' potential link to cause disseminated and invasive fungal infections.

Original languageEnglish (US)
Pages (from-to)e385-e391
JournalThe Lancet Infectious Diseases
Volume19
Issue number11
DOIs
StatePublished - Nov 2019

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Sporotrichosis
Pyoderma Gangrenosum
Immunosuppression
Skin
Fungi
Sporothrix
Teaching Rounds
Infection
Ulcer
Soil
Inflammation
Biopsy

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Disseminated sporotrichosis following iatrogenic immunosuppression for suspected pyoderma gangrenosum. / White, Marissa; Adams, La'Tonzia T.; Phan, Casey; Erdag, Gulsun; Totten, Marissa; Lee, Richard; Lu, Xuelian; Mehta, Seema; Miller, Lloyd S.; Zhang, Sean X.

In: The Lancet Infectious Diseases, Vol. 19, No. 11, 11.2019, p. e385-e391.

Research output: Contribution to journalReview article

White, Marissa ; Adams, La'Tonzia T. ; Phan, Casey ; Erdag, Gulsun ; Totten, Marissa ; Lee, Richard ; Lu, Xuelian ; Mehta, Seema ; Miller, Lloyd S. ; Zhang, Sean X. / Disseminated sporotrichosis following iatrogenic immunosuppression for suspected pyoderma gangrenosum. In: The Lancet Infectious Diseases. 2019 ; Vol. 19, No. 11. pp. e385-e391.
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