This is a report of a sporotrichosis case in a immunocompetent host: DJF, a 50 years old female veterinarian, admitted in an ambulatory of infecto-parasitic dermatoses in 2022. Her chief complaint was a hand wound with 1 month of evolution. Patient reported that she had been bitten by a cat 1 month prior, followed by local swelling, pain and erythema. She had already been medicated with antibiotics. After these treatments there was only partial improvement - in dermatologic examination the physician could still see nodular lesions on the back and palm of the right hand, at the site of the cat's bite, with erythema, swelling and local pain, measuring 1cm. There was also central ulceration in both lesions with sero-hematic crust and purulent discharge. She took care of sick animals at work, but reports that the biting animal was healthy at the time of the accident. In the 1st aproach serological exam for sporotrichosis and image exams were requested. The serology came out positive, US showed proliferative and exudative synovitis in metacarpophalangeal joint of the right 2nd finger, with limitation of movement. CT revealed bone erosion in the 2nd metacarpophalangeal joint associated with moderate joint effusion and enlargement and obliteration of adjacent soft tissues. Thus, in the 2nd appointment we could confirm sporotrichosis with osteoarticular involvement, but could not discard the hypothesis of bacterial infection. Although the lesion improved significantly, this time presenting only 2 scar lesions <1cm on the back and palm of the right hand with mild edema and local pain, treatment with itraconazol 200mg 12/12h and amoxicillin + clavulanate 500 mg 8/8h 4 weeks was established. The patient was also referred to an orthopedic center and occupational therapy. Other data will be presented when the patient returns.

ESDR169 - Diagnosis of osteoarticular sporotrichosis in a immunocompetent female

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