A Case of Disseminated Sporotrichosis Treated with Prednisolone, Immunosuppressants, and Tocilizumab under the Diagnosis of Rheumatoid Arthritis
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- Yamaguchi Tetsuto
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Ito Satoshi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan Department of Rheumatology, Niigata Rheumatic Center, Japan
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- Takano Yohei
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Umeda Naoto
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Goto Mizue
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Horikoshi Masanobu
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Hayashi Taichi
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Goto Daisuke
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Matsumoto Isao
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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- Sumida Takayuki
- Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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Abstract
We encountered a disseminated sporotrichosis patient with polyarthritis and progressive skin ulcers, who had been previously treated with prednisolone, tocilizmab, tacrolims, and cyclophosphamide under the diagnosis of rheumatoid arthritis in another hospital. Making the diagnosis of leukocytoclasticvasculitis based on the clinical observation of skin ulcers, we intensified immunosuppressive therapy. Unfortunately, the patient developed septic shock. Blood culture revealed that the pathogenic organism was sporothrixschenckii. Any case of intractable arthritis or skin ulcers, which does not improve, despite adequate immunosuppressive therapy, is likely to be suspicious of sporotrichosis.<br>
Journal
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- Internal Medicine
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Internal Medicine 51 (15), 2035-2039, 2012
The Japanese Society of Internal Medicine