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Martínez-Herrera E, Arenas R, Hernández-Castro R, Frías-De-León MG, Rodríguez-Cerdeira C. Uncommon Clinical Presentations of Sporotrichosis: A Two-Case Report. Pathogens 2021; 10:pathogens10101249. [PMID: 34684198 PMCID: PMC8541424 DOI: 10.3390/pathogens10101249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/18/2021] [Accepted: 09/22/2021] [Indexed: 01/19/2023] Open
Abstract
Sporotrichosis is a subcutaneous endemic mycosis caused by species of the Sporothrix schenckii complex. The most common clinical form of the disease is lymphocutaneous, while the fixed cutaneous and disseminated cutaneous forms are rare. Moreover, it is more prevalent in immunocompetent individuals. In this study, we present two cases of sporotrichosis with uncommon clinical forms: fixed cutaneous (Case 1) and disseminated cutaneous (Case 2). Both cases were diagnosed in immunocompetent males from endemic regions in Mexico, who had at least 1 year of evolution without improvement in response to prior nonspecific treatments. The diagnosis of sporotrichosis caused by S. schenckii sensu stricto was established through the isolation of the pathogen and its identification through the amplification of a 331 bp fragment of the gene encoding calmodulin. In both cases, improvement was observed after treatment with potassium iodide. Cases 1 and 2 illustrate the rarity of these clinical forms in individuals residing in endemic areas; hence, it is important to ensure a high index of clinical suspicion for the diagnosis of mycosis, as the differential diagnoses vary widely.
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Affiliation(s)
- Erick Martínez-Herrera
- Research Unit, Regional Hospital of High Specialty of Ixtapaluca, Ixtapaluca 56530, Mexico; (E.M.-H.); (M.G.F.-D.-L.)
- Postgraduate Studies and Research Section, Higher School of Medicine, National Polytechnic Institute, Mexico City 11340, Mexico
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain;
| | - Roberto Arenas
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain;
- Department of Mycology, General Hospital “Dr. Manuel Gea González”, Mexico City 14080, Mexico
| | - Rigoberto Hernández-Castro
- Department of Ecology of Pathogens, General Hospital “Dr. Manuel Gea González”, Mexico City 14080, Mexico;
| | - María Guadalupe Frías-De-León
- Research Unit, Regional Hospital of High Specialty of Ixtapaluca, Ixtapaluca 56530, Mexico; (E.M.-H.); (M.G.F.-D.-L.)
| | - Carmen Rodríguez-Cerdeira
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain;
- Department of Dermatology, Hospital Vithas Ntra. Sra. de Fátima and University of Vigo, 36206 Vigo, Spain
- Campus of Vigo, University of Vigo, 36310 Vigo, Spain
- Correspondence: ; Tel.: +34-600-536-114
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