title: The difficult management of disseminated Sporothrix brasiliensis in a patient with advanced AIDS.
abstract: Sporotrichosis is an infection caused by a dimorphic fungus of the Sporothrix schenckii complex. Host immunity is an important factor in the clinical manifestations of the disease. Deeply immunocompromised individuals, especially those infected with the Human Immunodeficiency Virus (HIV) and T CD4 counts < 350 cells/ul lymphocytes, may present with the systemic form of sporotrichosis. This report describes a case of disseminated sporotrichosis caused by S. brasiliensis in a patient with advanced AIDS. The skin, lungs, bones and central nervous system were affected. Medical treatment involved the administration of amphotericin B, terbinafine, itraconazole and posaconazole. Posaconazole was associated with the best clinical response and clearing of the fungus from the central nervous system.
authors.affiliation: Fundação Oswaldo Cruz - Fiocruz, Universidade Grande Rio, Rio de Janeiro, RJ Brazil.
authors.forename: Ariane Gomes
authors.initials: AG
authors.lastname: Paixão
authors.affiliation: Fundação Oswaldo Cruz - Fiocruz, Universidade Grande Rio, Rio de Janeiro, RJ Brazil.
authors.forename: Maria Clara Gutierrez
authors.initials: MCG
authors.lastname: Galhardo
authors.affiliation: Fundação Oswaldo Cruz - Fiocruz, Universidade Grande Rio, Rio de Janeiro, RJ Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Almeida-Paes
authors.affiliation: Fundação Oswaldo Cruz - Fiocruz, Universidade Grande Rio, Rio de Janeiro, RJ Brazil.
authors.forename: Estevão Portela
authors.initials: EP
authors.lastname: Nunes
authors.affiliation: Fundação Oswaldo Cruz - Fiocruz, Universidade Grande Rio, Rio de Janeiro, RJ Brazil.
authors.forename: Marcelo Luiz Carvalho
authors.initials: MLC
authors.lastname: Gonçalves
authors.affiliation: Fundação Oswaldo Cruz - Fiocruz, Universidade Grande Rio, Rio de Janeiro, RJ Brazil.
authors.forename: Gisele Larias
authors.initials: GL
authors.lastname: Chequer
authors.affiliation: Fundação Oswaldo Cruz - Fiocruz, Universidade Grande Rio, Rio de Janeiro, RJ Brazil.
authors.forename: Cristiane da Cruz
authors.initials: CDC
authors.lastname: Lamas
keywords: AIDS; Amphotericin B; Posaconazole; Sporotrichosis