Disseminated Sporothrix brasiliensis Infection with Endocardial and Ocular Involvement in an HIV-Infected Patient

Mario León Silva-Vergara Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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Zoilo Pires de Camargo Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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Patricia Ferreira Silva Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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Michel Reis Abdalla Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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Ricardo Nilsson Sgarbieri Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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Anderson Messias Rodrigues Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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Keila Cristina dos Santos Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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Cristina Hueb Barata Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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Kennio Ferreira-Paim Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil

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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.

Author Notes

* Address correspondence to Mario León Silva-Vergara, Tropical Medicine, Postal Code 118, CEP: 38001-170, Uberaba, Minas Gerais, Brazil. E-mail: marioleon.dip@mednet.com.br

Financial support: We thank Fundação de Amparo à Pesquisa de Minas Gerais (FAPEMIG) for financial support (Grant PQ1813/09).

Authors’ addresses: Mario León Silva-Vergara, Patricia Ferreira Silva, Michel Reis Abdalla, Ricardo Nilsson Sgarbieri, Keila Cristina dos Santos, Cristina Hueb Barata, and Kennio Ferreira-Paim, Infectious and Parasitic Diseases Unit, Hospital de Clínicas, Federal University of the Triângulo Mineiro, Uberaba, Minas Gerais, Brazil, E-mails: marioleon.dip@mednet.com.br, pfsilva1981@yahoo.com.br, michel_reis_abdalla@hotmail.com, rsgarbieri@uol.com.br, keila-bio@hotmail.com, chueb@terra.com.br, and kennio_p@hotmail.com. Zoilo Pires de Camargo and Anderson Messias Rodrigues, Microbiology, Immunology and Parasitology Unit, Federal University of São Paulo, São Paulo, Brazil, E-mails: zpcamargo@unifesp.br and rodriguesbio@yahoo.com.br.

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