Lymphocutaneous sporotrichosis: clinical suspicion when lesion is refractory to antibacterial treatment

• Main Authors: Che' Man, Mohamad, Wan Mahmud, Wan Fatimah Suriyani, Ismail, Rasimah
• Format: Article
• Language: English
• Published: The Ministry of Health and Universiti Brunei Darussalam 2022
• Subjects: R Medicine (General); RA Public aspects of medicine
• Online Access: http://irep.iium.edu.my/99655/1/99655_Lymphocutaneous%20sporotrichosis.pdf; http://irep.iium.edu.my/99655/

Sporotrichosis is a fungal infection caused by Sporothrix schenckii. It occurs worldwide especially in tropical and subtropical areas. It manifests as lymphocutaneous skin, fixed cutaneous or dis�seminated lesion following exposure to contaminated source like animals, plants, or abiotic com�ponents. We report a case of a 75-year-old lady with right foot ulcerative nodule which was re�fractory to repeated antibacterial treatment, and cultures were all negative including mycobacte�rium and fungus. Skin punch biopsy was also negative for granuloma or malignancy. Based on the history, physical examination and investigation findings, a clinical suspicion of lymphocutane�ous sporotrichosis was made. The patient was started on an empirical course of itraconazole 200mg od. The lesions responded well with 12 weeks of treatment. As clinicians we are occasion�ally faced with cases where investigations may not yield results that are helpful towards making a diagnosis and in such situations, we may need to start empirical treatment based on our best judgement.