| Summary: | Sporotrichosis is a neglected zoonotic disease caused by Sporothrix
spp., which has impact on animal and human health. It manifests in
humans by inoculation of the fungus after skin trauma, by scratching
and/or biting animals. Diagnosis is clinical, epidemiological and
laboratorial. Treatment is performed with azolic compounds, usually
without complications. The present work aims to report a clinical case
of occupational sporotrichosis with an atypical evolution, which is
refractory to conventional treatment with itraconazole. A 25-year-old
immunocompetent student of Veterinary Medicine from Belo Horizonte/
MG was scratched by a two-year-old feline positive for sporotrichosis.
Seven days post-infection she presented with a pruritic, erythematous
nodular lesion on her right arm. Fungal culture obtained from the
lesion has shown the growth of Sporothrix spp. At thirty days, a localized
ulcerated lesion developed, with purulent exudation. After a ten-week
treatment with itraconazole, the localized cutaneous form evolved to an
atypical picture of hypersensitivity reaction/immunoreactive cutaneous
sporotrichosis. At nine months, the picture evolved to emesis, hyporexia,
alopecia, headache, myalgia, hematokezia, laboratory changes in liver
enzymes, and anemia. The evolution was atypical and prolonged, with
features of therapeutic failure and drug toxicity reactions. After eleven
months, the therapeutic regimen was revised and a new therapy with
amphotericin B was initiated, until the resolution of the infection, and
total recovery took place at 13 months. This report alerts physicians
and health professionals to the occurrence of atypical manifestations of
sporotrichosis, failure to conventional therapy, and drug toxicity, and
suggests a discussion about this new facet of sporotrichosis.
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