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Disseminated subcutaneous sporotrichosis in an immunocompetent patient: A case report and a systematic literature review

Summary

A 74-year-old man developed painful red masses on his arm and hand after being stuck by a tree branch. Tests identified the infection was caused by a fungus called Sporothrix schenckii. Despite having a normal immune system, the infection had spread across his arm in an unusual pattern. Treatment with an antifungal medication called itraconazole completely healed the lesions within four months without any scarring.

Background

Sporotrichosis is a subacute and chronic infectious disease caused by infection of the skin, subcutaneous tissues, and lymphatic vessels by the sporotrichosis complex. Disseminated subcutaneous sporotrichosis is typically seen in immunocompromised patients, making cases in immunocompetent individuals relatively rare.

Objective

To report a case of disseminated subcutaneous sporotrichosis in an immunocompetent patient and provide a systematic literature review of all case reports of disseminated subcutaneous sporotrichosis with species identification.

Results

The patient had sporadic red masses with local ulceration on the right forearm, wrist, and little finger. mNGS identified Sporothrix schenckii as the causative agent. Literature review identified 16 documented cases: 31.8% caused by S. schenckii, 54.5% by S. brasiliensis, and 13.6% by S. globosa. Treatment with itraconazole resulted in complete healing without scarring or pigmentation after 4 months.

Conclusion

Disseminated subcutaneous sporotrichosis can occur in immunocompetent patients, possibly related to strain virulence and delayed antifungal treatment. mNGS testing provides rapid and accurate diagnosis, guiding appropriate antifungal therapy. Itraconazole is the preferred treatment choice for disseminated cutaneous sporotrichosis.
  • Published in:Medical Mycology Case Reports,
  • Study Type:Case Report with Systematic Literature Review,
  • Source: PMID: 41079969; DOI: 10.1016/j.mmcr.2025.100739
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