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Case Reports in Infectious Diseases
Volume 2017 (2017), Article ID 4713140, 5 pages
https://doi.org/10.1155/2017/4713140
Case Report

Rapidly Progressive Disseminated Sporotrichosis as the First Presentation of HIV Infection in a Patient with a Very Low CD4 Cell Count

Hospital Universitário Gaffrée e Guinle, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rua Mariz e Barros 775, Tijuca, 20270-004 Rio de Janeiro, RJ, Brazil

Correspondence should be addressed to Walter de Araujo Eyer-Silva; rb.moc.gi@reye.retlaw

Received 27 April 2017; Accepted 9 July 2017; Published 25 September 2017

Academic Editor: Jean-François Faucher

Copyright © 2017 Isis Cristine Morávia Ribeiro de Oliveira-Esteves et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sporotrichosis is a human and animal disease caused by species of the Sporothrix schenckii complex. It is classically acquired through traumatic inoculation of fungal elements. Most frequently, sporotrichosis presents as a fixed cutaneous or as a lymphocutaneous form. A much smaller number of cases occur as cutaneous disseminated and disseminated forms. These cases require immediate diagnosis and management to reduce morbidity and mortality. We present the case of a 34-year-old male patient in whom the first presentation of HIV infection was a rapidly progressive sporotrichosis with multiple cutaneous lesions, a high fungal burden in tissues, and pulmonary involvement. He had an extremely low CD4 cell count (06/). Treatment with amphotericin B deoxycholate led to complete clinical resolution. Sporotrichosis remains a neglected opportunistic infection among HIV-infected patients in Rio de Janeiro state, Brazil, and awareness of this potentially fatal infection is of utmost importance if treatment is not to be delayed and if potentially devastating complications are to be avoided.