Fatal pulmonary sporotrichosis caused by Sporothrix brasiliensis in Northeast Brazil

PLoS Negl Trop Dis. 2020 May 26;14(5):e0008141. doi: 10.1371/journal.pntd.0008141. eCollection 2020 May.

Abstract

Background: A relevant case of pulmonary sporotrichosis due to Sporothrix brasiliensis is reported in a 50-year-old immunocompetent woman who had no history of skin trauma, but was in close contact with several stray cats at her nap time. The patient was hospitalized after 7 months of illness. The survey was conducted for pulmonary tuberculosis, an endemic disease in Brazil. She presented multiple central pulmonary nodules images, with central cavitation.

Methodology/principal findings: The patient bronchoalveolar lavage was cultured and Sporothrix sp. growth was obtained. Then, the isolate (LMMM1097) was accurately identified to the species level by using species-specific polymerase chain reaction (PCR). Molecular diagnosis revealed that the emerging species Sporothrix brasiliensis was the agent of primary pulmonary sporotrichosis and the patient was treated with Amphotericin B lipid complex, but presented severe clinical symptoms and the fatal outcome was observed at day 25 after hospitalization.

Conclusions/significance: Our report adds important contributions to the clinical-epidemiological features of sporotrichosis, showing the geographic expansion of the agent within different regions of Brazil and a rare clinical manifestation (primary pulmonary sporotrichosis) caused by the emerging agent S. brasiliensis in an immunocompetent female patient.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil
  • Fatal Outcome
  • Female
  • Humans
  • Immunocompetence
  • Lung Diseases, Fungal / pathology*
  • Lung Diseases, Fungal / therapy
  • Middle Aged
  • Sporothrix / classification*
  • Sporothrix / isolation & purification
  • Sporotrichosis / pathology*
  • Sporotrichosis / therapy

Grants and funding

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This study was partially financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES) – Finance Code 001. GMC is a research productivity fellow of the National Council for Scientific and Technological Development (CNPq) and AMR is a fellow of São Paulo Research Foundation (FAPESP 2017/27265-5) and CNPq (433276/2018-5).