Cutaneous disseminated sporotrichosis associated with diabetes: A case report and literature review

PLoS Negl Trop Dis. 2023 Sep 18;17(9):e0011647. doi: 10.1371/journal.pntd.0011647. eCollection 2023 Sep.

Abstract

Background: Cutaneous disseminated sporotrichosis (CDS), also called hematogenous sporotrichosis, is a rare condition that usually affects immunocompromised patients. The current work presents the case of a woman with diabetes mellitus associated with CDS.

Case presentation: A 59-year-old woman with diabetes mellitus presented with a two-year history of ulcerated rashes on the left ankle and both sides of the jaw. Physical examination revealed three annular areas of erythematous and raised plaque with an ulcer over the left ankle and both sides of the jaw. Based on laboratory findings, elevated blood glucose concentration and decreased white cell count were observed. Sporothrix globosa was identified in the mycological culture of biopsied tissue from the three lesions and this was confirmed by DNA sequencing. The skin lesions healed after two-month itraconazole therapy.

Conclusions: Diabetes is a risk factor for disseminated sporotrichosis, which may be induced by hematogeneous spread, repeated inoculation, or autoinoculation. This study raises awareness among clinicians, with regard to the notion that people with possibly altered immune function are potentially vulnerable to severe clinical forms of sporotrichosis.

Publication types

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

MeSH terms

  • Antifungal Agents / therapeutic use
  • Diabetes Mellitus*
  • Female
  • Humans
  • Itraconazole / therapeutic use
  • Middle Aged
  • Skin / pathology
  • Sporothrix*
  • Sporotrichosis* / complications
  • Sporotrichosis* / diagnosis
  • Sporotrichosis* / drug therapy

Substances

  • Antifungal Agents
  • Itraconazole

Grants and funding

This work was supported by a grant from the Hangzhou Science and Technology Bureau (http://kj.hangzhou.gov.cn) grant 202004A17 to ZHL. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.