Esporotricosis linfangítica en un paciente con insuficiencia hepática
Por:
Méndez-Tovar L.J., Garibay-Partida A.J., Vázquez-Hernández A.
Publicada:
1 ene 2019
Categoría:
Dermatology
Resumen:
Sporotrichosis is the most frequent subcutaneous mycosis in Mexico; the mechanism of infection is the traumatic inoculation of dimorphic hyaline fungi Sporothrix schenckii complex. There are different clinical varieties, such as: fixed, lymphangitic, pulmonary and disseminated, which will depend mainly on the immunological status of the patients. Azoles are among the first line treatments; however, they cannot always be prescribed, especially in those patients with liver compromise. We report the case of a 17-year-old farmer patient from Queretaro, Mexico. The patient presented a chronic ulcer as a consequence of a trauma with shrubs, for which he did not receive medical attention, later he presented varicella complicated with encephalitis for which he received phenytoin and as a consequence he developed a drug sensitization syndrome with eosinophilia and fever (DRESS) for which he was immunosuppressed, presenting lymphangitic dissemination of the initial ulcer. The mycological culture was negative, the diagnosis of sporotrichosis was established by histopathology; however, the patient persisted with hepatic affection as a result of DRESS; it could not be given optimal doses of azoles, so, patient received itraconazole 100 mg/day for three months, presenting a favorable evolution. We report the case due to the importance of an exhaustive dermatological examination prior to the immunosuppression of the patients, in addition to the therapeutic challenge of having a liver condition. © 2019 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.
Filiaciones:
Méndez-Tovar L.J.:
Laboratorio de Investigación Médica en Dermatología y Micología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, Mexico
Garibay-Partida A.J.:
Laboratorio de Investigación Médica en Dermatología y Micología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, Mexico
Vázquez-Hernández A.:
Laboratorio de Investigación Médica en Dermatología y Micología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, Mexico
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