Disseminated sporotrichosis with extensive cutaneous involvement in a patient with AIDS

Sporotrichosis most commonly presents as a localized, lymphocutaneous infec tion that follows trauma, such as an injury from a rose thorn. In patients infected with HIV, it may be widespread and disseminated. We describe a pat ient with AIDS who developed disseminated sporotrichosis, a rare opportunis tic fungal infection that may affect these patients. The condition remained undiagnosed because of failure to recognize characteristic histopathologic findings and failure of clinicians to interface closely with the microbiol ogy laboratory. The condition was difficult to treat, requiring systemic ad ministration of amphotericin. While localized sporotrichosis is an innocuou s disorder that responds well to therapy, in immunocompromised hosts, it is potentially life-threatening and may require prolonged therapy with potent ially toxic medications such as amphotericin B. It is important that clinic ians be aware of the presentation of this unusual opportunistic infection a nd that they maintain close communication with pathology and clinical micro biology laboratories to ensure that proper stains and cultures are performe d to avoid potential misdiagnosis.