Table 3.
Characteristics of patients with central nervous system sporotrichosis (Group 1).
| Patient | Sex/Age a (yo) | Predisposing Condition | Duration of Neurological Symptoms | Clinical Manifestations | Initial CSF Findings | CSF Sporothrix spp. Detection b | Radiological Features | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| 1 | M/44 | HIV infection | 15 days | Headache, right III nerve palsy, cognitive complaints | 363 cells/mm3 (91%MN), P: 410 mg/dL; G: 31 mg/dL | Positive Sporothrix spp. PCR |
Left thalamus ischemic stroke | AmB + posaconazole | Deceased |
| 2 | M/57 | HIV infection | 1 month | Headache | 90 cells/mm3 (100%MN), P: 63.9 mg/dL; G:48 mg/dL | No | None | AmB + posaconazole | Ongoing treatment (AmB) |
| 3 | M/28 | HIV infection | 2 months | Headache, vomiting, nuchal rigidity | 206 cells/mm3 (90%MN), P: 159 mg/dL; G: 24 mg/dL | No | Meningeal contrast enhancement | AmB | Cured |
| 4 | M/46 | HIV infection | 4 months | Headache, vomiting, nuchal rigidity, cognitive complaints | 12 cells/mm3 (86%MN), P: 293 mg/dL; G: 22 mg/dL | No | Hydrocephalus, right internal capsule ischemic stroke | AmB | Deceased |
| 5 | M/26 | HIV infection | 15 days | Headache, nuchal rigidity, lethargy, seizures | 6 cells/mm3 (100%MN), P: 307 mg/dL; G: 27 mg/dL | Positive culture | Hydrocephalus, meningeal contrast enhancement, and nodular lesion in the right cerebellar hemisphere | AmB | Deceased |
| 6 | M/37 | HIV infection | 1 month | Headache, seizures | 10 cells/mm3 (100%MN), P: 97.5 mg/dL; G: 52 mg/dL | No | None | Itraconazole | Deceased |
| 7 | M/41 | Alcoholism | 1 month | Drowsiness, nuchal rigidity | 79 cells/mm3 (78%MN), P: 162 mg/dL; G: 32 mg/dL | No | None | AmB | Deceased |
| 8 | M/48 | HIV infection | 15 days | Headache, vomiting, seizures | 4 cells/mm3 (98%MN), P: 61.6 mg/dL; G: 35 mg/dL | Positive culture | Hydrocephalus | AmB | Deceased |
| 9 | F/21 | HIV infection | 1 month | Headache, right VI nerve palsy, drowsiness, nuchal rigidity | 3 cells/mm3 (100%MN), P: 33 mg/dL; G: 59 mg/dL | Positive culture | Hydrocephalus, meningeal contrast enhancement | AmB + posaconazole | Deceased |
| 10 | M/40 | HIV infection | 2 months | Headache, vomiting, drowsiness, cognitive complaints | 12 cells/mm3 (97%MN), P: 32 mg/dL; G: 65 mg/dL | No | Hydrocephalus, meningeal contrast enhancement | AmB | Deceased |
| 11 | M/28 | Leprosy and chronic steroid use | 2 months | Headache | 133 cells/mm3 (37%MN), P: 278 mg/dL; G: 58 mg/dL | Positive culture | None | AmB | Asymptomatic but with persistent CSF abnormalities |
| 12 | F/31 | HIV infection | 1 month | Headache, vomiting, motor deficit, seizures, drowsiness | 25 cells/mm3 (90%MN), P: 61 mg/dL; G: 10 mg/dL | Positive Sporothrix spp. PCR |
Hydrocephalus, meningeal, contrast enhancement, right parietal hemorrhagic stroke | AmB + posaconazole | Deceased |
| 13 | M/38 | HIV infection | 1 month | Vomiting, cognitive complaints | 86 cells/mm3 (64%MN), P: 74.2 mg/dL; G: 35 mg/dL | Positive culture | Hydrocephalus | AmB | Deceased |
| 14 | M/43 | HIV infection | 8 months | Headache, vomiting, VI nerve palsy, drowsiness | 15 cells/mm3 (100%MN), P: 47.5 mg/dL; G: 53 mg/dL | Positive Sporothrix spp. PCR |
Hydrocephalus, meningeal contrast enhancement | AmB | Cured |
| 15 | M/23 | HIV infection | 15 months | Headache, vomiting, nuchal rigidity, drowsiness | 72 cells/mm3 (100%MN), P: 100 mg/dL; G: 34 mg/dL | Positive Sporothrix spp. PCR |
Hydrocephalus, meningeal contrast enhancement | AmB + posaconazole | Cured |
| 16 | M/35 | HIV infection | 2 months | Headache, vomiting, drowsiness | 5 cells/mm3 (100%MN), P: 42.5 mg/dL; G: 57 mg/dL | Positive culture | None | AmB | Deceased |
| 17 | M/20 | HIV infection | 3 months | Headache | 86 cells/mm3 (75%MN), P: 68.6 mg/dL; G: 35 mg/dL | Positive culture | Meningeal contrast enhancement | AmB + posaconazole | Ongoing treatment (AmB) |
a Age at onset; b Sporothrix spp. PCR reported by Oliveira et al., 2020 [12]. Yo: years-old; M: male; F: female; CSF: cerebrospinal fluid; P: proteins; G: glucose; PCR: polymerase chain reaction; MN: mononuclear cells; AmB: amphotericin B.