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Transplant Proc. 2019 Jun;51(5):1621-1624. doi: 10.1016/j.transproceed.2019.02.019.

Disseminated Sporotrichosis in a Liver Transplant Patient: A Case Report.

Author information

1
Liver Transplantation Division, Federal District Institute of Cardiology, Brasília, Brazil. Electronic address: arantesferreira@yahoo.com.br.
2
Liver Transplantation Division, Federal District Institute of Cardiology, Brasília, Brazil.
3
Medical School, Chatolic University of Brasilia, Brasília, Brazil.

Abstract

Sporotrichosis is an infection caused by the fungus of the Sporothrix schenckii complex and can be particularly harmful in immunocompromised patients. We report the case of a 26-year-old male patient with a previous history of pulmonary infection who underwent a liver transplant for Budd-Chiari syndrome. After the procedure, he presented with persistent fever and leukocytosis. On the 13th post-operative day, he was diagnosed with thrombosis of the hepatic artery and underwent a second liver transplant 15 days after the first procedure. After the retransplant, he presented daily episodes of fever, even after the use of several antimicrobial, antiviral, and antifungal agents. A number of negative cultures from different sites were obtained. After an acute episode of mental confusion, the growth of S schenckii was observed in cultures from cerebrospinal fluid and ascites obtained from a diagnostic paracentesis. Treatment with amphotericin B was started but the patient died on the fourth day of antifungal treatment, from a massive gastrointestinal hemorrhage. We found no previous report in the literature of spontaneous dissemination of S schenckii to the abdominal cavity causing peritonitis.

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