Disseminated sporotrichosis presenting with granulomatous inflammatory multiple mononeuropathies.
We describe a case of sporotrichosis that disseminated to involve multiple nerves after initiation of immunosuppressive therapy and then precipitously worsened after withdrawal of therapy. This case illustrates that multiple mononeuropathies are not always caused by vasculitis, and a correct pathological diagnosis should be established before treatment. Based on clinical and pathological features, the mechanism of neuropathy may have been due to either direct nerve infection or a bystander effect of inflammatory/immune damage or, perhaps more likely, to both mechanisms.
Mauermann
Michelle L
ML
Department of Neurology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, Minnesota 55905, USA.
Klein
Christopher J
CJ
Orenstein
Robert
R
Dyck
P James B
PJ
D000038:Abscess / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D000666:Amphotericin B / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D003646:Debridement; D003872:Dermatitis / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D003951:Diagnostic Errors; D018450:Disease Progression; D005542:Forearm / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D006105:Granulomatous Disease, Chronic / Q000382:microbiology* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007249:Inflammation / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D010525:Peripheral Nerves / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000382:microbiology* / Q000473:pathology* / Q000503:physiopathology; D013175:Sporothrix / Q000302:isolation & purification; D013174:Sporotrichosis / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D000666:Amphotericin B