Fatal pulmonary sporotrichosis caused by Sporothrix brasiliensis in Northeast Brazil

by Manoella do Monte Alves, Eveline Pipolo Milan, Walicyranison Plinio da Silva-Rocha, Alexandre Soares de Sena da Costa, Bruno Araújo Maciel, Pedro Henrique Cavalcante Vale, Paulo Roberto de Albuquerque, Soraia Lopes Lima, Analy Salles de Azevedo Melo, Anderson Messias Rodrigues, Guilherme Maranhão Chaves

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.