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A 32-year-old man worked as a subsistence farmer raising pigs and tending his small garden; he also kept cats and dogs. He reported fever, night sweats, weight loss of 10 kg over 3 months, haemoptysis and skin ulcers (figure 1). Radiography and chest CT scan (figure 2) showed extensive bilateral cavities. An HIV test was negative. Bronchoalveolar lavage and biopsy of the skin lesions displayed Sporothrix schenckii. He was treated with amphotericin B and his lesions slowly healed.
Sporotrichosis is a chronic pyogranulomatous infection caused by a dimorphic fungus that contaminates skin or subcutaneous tissue after trauma with plant materials such as thorns or splinters, or through cat scratches or bites.1–3 The term ‘Rose Gardener's disease’ has been coined following the observation of the disease in gardeners, farmers, forestry and nursery workers, veterinary workers and outdoor labourers.1 ,2 ,4 Primary pulmonary disease is extremely rare, and other diagnosis such as tuberculosis and cryptococcosis should be considered.1 ,4 We believe that this patient's pulmonary cavities are reflective of disease dissemination.
Competing interests None.
Ethics approval Ethics committee from State University of Rio de Janeiro 2011.
Provenance and peer review Not commissioned; internally peer reviewed.