Graph 1.
Number of cases of sporotrichosis and bone sporotrichosis seen historically at the INI-Fiocruz (1986 to 2016).
(Source: Electronic data system of patients and database of the Laboratory of Clinical Research in Infectious Dermatology of the INI).
Table 1.
Description of the initial clinical form, comorbidities and bones affected, of the patients with bone sporotrichosis, treated at the INI-Fiocruz, from 1999 to 2016.
Fig 1.
Bone sporotrichosis histopathology (case 31).
A) Bone trabeculae next to connective tissue with chronic inflammatory process (Hematoxylin and eosin, 20X). B) Connective tissue with mononuclear inflammatory infiltrate and giant cell reaction (Hematoxylin and eosin, 40X). C) Yeast-like structures (dark rounded) (Grocott’s Methenamine Silver, 40X). (Source: courtesy of Dr. Janice Mery Chicarino de Oliveira Coelho).
Fig 2.
Different imaging diagnosis in bone sporotrichosis.
A-C (case 40): A) Bone scintigraphy screening demonstrating uptake of the radiopharmaceutical in the right knee, left ankle, and foot. B-C) Magnetic resonance of the left ankle and foot—Round and well-defined lithic lesions in the tibia, calcaneus, and cuneiform. (Source: Laboratory of Clinical Research in Infectious Dermatology). D-I (case 22): D-E) Radiographs—Lytic lesions in the tibia, fibula, and calcaneus. F-G) Same lesions seen on computed tomography. H-I) Radiographs 11 months later, showing resolution of the lesions. The lesions are pointed by the red arrows. (Source: Service of Image of the INI).
Fig 3.
A) Extensive ulcerated sporotrichosis lesions on the left upper limb and trunk. B) Hands with edema, more noticeable to the right (clinical images were inverted to correspond to the radiographs). C) Radiography—Multiple lytic lesions and bone erosions in both hands (arrows). (Source: A-B—Images by Dr. Marcelo Rosandiski Lyra; C–Service of Image of the INI).
Fig 4.
A) Exuberant ulcerated lesion of fixed cutaneous sporotrichosis, with first right finger volume increase. B) Radiography—Destruction of the distal phalanx of the first right finger, with swelling of soft tissue (arrow). C-D) Clinical and radiological improvement after 9 months (arrow). (Source: A, C—Laboratory of Clinical Research in Infectious Dermatology; B, D—Service of Image of the INI).
Table 2.
Association of selected variables with the type (unifocal/multifocal) of bone involvement, for patients with bone sporotrichosis treated at the INI-Fiocruz, from 1999 to 2016.
Fig 5.
Patient infected with HIV, multifocal bone sporotrichosis (case 6).
A) Patient with disseminated sporotrichosis and advanced AIDS. Multiple pleomorphic ulcerated lesions. Radiographs—B) Multiple lytic lesions with destruction of the proximal phalanx of the first right finger. C) Lytic lesions in the right wrist. D) Lytic lesions along the left tibia and fibula. The lesions are pointed by the red arrows. (Source: A—Laboratory of Clinical Research in Infectious Dermatology; B-D—Service of Image of the INI).
Table 3.
Treatment and clinical evolution of patients with bone sporotrichosis treated at the INI-Fiocruz between 1999 and 2016.