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Polyarticular Sporothrix schenckii Infection In an Immunocompetent Host
D L Saaibi1, L R Zúñiga-Montes, M Charry-Barrios
1University of Pennsylvania, Philadelphia, Pennsylvania (D.L.S.) and Universidad Nacional de Colombia, Colombia (L.R.Z.-M., M.C.-B., M.P., L.F.P., F.R., J.F.R., F.M., A.I.).
Summary
Septic arthritis from Sporothrix schenckii is rare and hard to diagnose. This case highlights disseminated infection and polyarthritis in an immunocompetent patient, potentially worsened by steroids.
Area of Science:
- Mycology
- Infectious Diseases
- Rheumatology
Background:
- Septic arthritis is a severe joint infection.
- Sporothrix schenckii typically causes localized infections, with systemic dissemination being rare.
- Diagnosis of fungal arthritis, particularly Sporothrix schenckii, is challenging due to low organism density and specialized culture requirements.
Purpose of the Study:
- To report a rare case of disseminated Sporothrix schenckii infection presenting as polyarthritis.
- To emphasize the diagnostic difficulties associated with fungal septic arthritis.
- To discuss the potential impact of immunosuppressive therapy on the course of infection.
Main Methods:
- Case report of a patient with disseminated Sporothrix schenckii infection and polyarthritis.
- Review of clinical presentation, diagnostic workup, and treatment.
- Discussion of the role of prior steroid therapy.
Main Results:
- A polyarticular presentation of Sporothrix schenckii infection was observed.
- The patient was initially immunocompetent, making the disseminated fungal infection unusual.
- Steroid treatment for presumed vasculitis appeared to exacerbate the fungal infection.
Conclusions:
- Disseminated Sporothrix schenckii infection can manifest as septic arthritis, even in immunocompetent individuals.
- Early and accurate diagnosis is crucial but often delayed due to diagnostic challenges.
- Immunosuppressive therapy may worsen outcomes in disseminated fungal infections.
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