MRI: complex multi-compartment fluid collection with extensive flexor and extensor tenosynovitis
Debridement. Culture (photo).
What is your diagnosis and Rx?
#MayoIDQ MCQ to follow...
![Image](https://pbs.twimg.com/media/Ed3IzsAWoAA83PZ.jpg)
Which of the following is the exposure associated with this infection?
Beaver dam and blastomyces
When #IDBR says #beaverdam - you think #BLASTOMYCOSIS
nejm.org/doi/10.1056/NE…
#Spelunking and histoplasmosis
When #IDBR says spelunking - you think #Histoplasmosis
doi.org/10.1111/j.1708…
Insect bite and invasive mucocutaneous mycoses
RARE
Only 22 reports
Mucorales group is most common!
Others: Aspergillus, Sporothrix, Fusarium
doi.org/10.1093/ofid/o…
#Sporothricosis and sphagnum moss
When #IDBR says sphagnum moss - you think Sporothricosis
This is the suggested answer to the MCQ
What are the other exposures associated with sporothrix? Next...
#Sporothricosis
Soil and decaying vegetable and organic matter
- Hay
- Sphagnum moss
- Rose garden
Zoonotic- cat scratch and bite
- Endemic in Brazil
Sporotrichosis | Fungal Diseases | CDC
![Image](https://pbs.twimg.com/media/EeIB9UUXgAEtuzW.jpg)
Cat scratch/bite and sporothrix
Animal sporothricosis affects cats > dogs
Endemic in Rio de Janeiro / Brazil
Sporothrix brasiliensis
Transmitted to human: cat scratch and bites
ncbi.nlm.nih.gov/pmc/articles/P…
Case diagnosis: #Sporothricosis with extensive tenosynovitis
Treatment
- Itraconazole: preferred for localized disease (alternate: terbinafine, high dose fluconazole)
- Potassium iodide (historical Rx)
- Amphotericin B: severely ill patients