Disseminated cutaneous sporotrichosis associated with anergic immuno-suppression due to miliary tuberculosis

A 52-years-old policeman suffering from tuberculous meningitis, developed pseudo-umbilicated nodular skin lesions which increased rapidly in size during the course of his illness. Histology revealed cutaneous sporotrichosis. Human immuno-deficiency virus infection was excluded by absence of history of exposure and repeated negative serological test for HIV antibodies. The tuberculin test was also negative. Anti-tuberculous therapy failed to prevent a fatal outcome 3 months after admission to hospital. The possibility that the usually presentation of disseminated cutaneous sporotrichosis was an opportunistic infection facilitated by immuno-deficiency accompanying anergy of miliary tuberculosis is discussed.