title: Disseminated Sporothrix brasiliensis infection with endocardial and ocular involvement in an HIV-infected patient.
abstract: Disseminated sporotrichosis occurs in individuals with impaired cellular immunity, such as in cases of neoplasia, transplantation, diabetes, and especially, acquired immunodeficiency syndrome. This report presents a 32-year-old Brazilian human immunodeficiency virus (HIV)-infected patient who developed a protracted condition of disseminated sporotrichosis with endocarditis, bilateral endophthalmitis, and lymphatic involvement. He needed cardiac surgery to replace the mitral valve. Sporothrix brasiliensis isolates were recovered from cultures of subcutaneous nodules and mitral valve fragments. Species identification was based on classical and molecular methods. The patient received amphotericin B for 52 days and subsequently, oral itraconazole. He remains asymptomatic, and he is on maintenance therapy with itraconazole. Despite his positive clinical outcome, he developed bilateral blindness. To our knowledge, this case is the first report of endocarditis and endophthalmitis caused by S. brasiliensis.
authors.affiliation: Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil. marioleon.dip@mednet.com.br
authors.forename: Mario León
authors.initials: ML
authors.lastname: Silva-Vergara
authors.forename: Zoilo Pires
authors.initials: ZP
authors.lastname: de Camargo
authors.forename: Patricia Ferreira
authors.initials: PF
authors.lastname: Silva
authors.forename: Michel Reis
authors.initials: MR
authors.lastname: Abdalla
authors.forename: Ricardo Nilsson
authors.initials: RN
authors.lastname: Sgarbieri
authors.forename: Anderson Messias
authors.initials: AM
authors.lastname: Rodrigues
authors.forename: Keila Cristina
authors.initials: KC
authors.lastname: dos Santos
authors.forename: Cristina Hueb
authors.initials: CH
authors.lastname: Barata
authors.forename: Kennio
authors.initials: K
authors.lastname: Ferreira-Paim
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D009877:Endophthalmitis / Q000188:drug therapy*; D005123:Eye / Q000473:pathology*; D006678:HIV / Q000472:pathogenicity; D006760:Hospitalization; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D013175:Sporothrix / Q000302:isolation & purification*; D013174:Sporotrichosis / Q000188:drug therapy*; D016896:Treatment Outcome; D014785:Vision, Ocular
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B