# Systemic disseminated zoonotic sporotrichosis with multifocal bone involvement: A case report

## TL;DR

A woman with diabetes developed a rare fungal infection that spread to her bones and was successfully treated with surgery and antifungal medication.

## Contribution

This case report highlights the rare presentation of sporotrichosis with multifocal bone involvement and successful long-term treatment.

## Key findings

- The patient had progressive cutaneous lesions and bone involvement caused by Sporothrix spp.
- Surgical debridement and 1 year of itraconazole treatment led to complete resolution of lesions.
- No residual functional disabilities were observed during follow-up.

## Abstract

We report the case of a 54-year-old woman with poorly controlled type 2 diabetes mellitus, dyslipidaemia, hypertension and a 3-month history of fixed cutaneous sporotrichosis treated with itraconazole 200 mg once daily. She subsequently presented with progressive enlarging nodular lesions on her left forearm, wrist and right forehead, with right ankle pain. Imaging revealed multifocal osseous involvement, including small lucent lesions in the right frontal bone and left distal radius and aggressive lesions in the right ankle and left radius. MRI of the right ankle showed an enhancing lesion in the distal fibula with cortical destruction. A biopsy showed chronic suppurative granulomatous inflammation, and a fungal culture grew Sporothrix spp. The patient underwent surgical debridement of the ankle and was continued on itraconazole for 1 year. She had complete resolution of all her lesions, resulting in no residual functional disabilities observed during follow-up.