Lymphocutaneous sporotrichosis

Rationale: Sporotrichosis is a dermatomycosis caused by the dimorphic fungus Sporothrix schenckii sensu lato. The traditional gold standard for the definitive diagnosis of the disease is fungal culture. Our case describes the patient diagnosed lymphocutaneous sporotrichosis through the metagenomic next-generation sequencing (mNGS) quickly. Patient concerns: A 53-year-old male presented with protracted multiple ulcerated lesions. The pathological analysis of his skin biopsy specimen was inflammatory reaction, routine hematological and biochemistry examinations, the imaging of heart, lung and stomach were normal. Diagnoses: The wounds were received debridement in our ward. Sporothrix schenckii was identified by the culture and the mNGS of the wound pus. Interventions: Following definitive diagnosis, oral itraconazole was administered to the patient; meanwhile, regular clinical follow-up visits and reevaluations were scheduled for continuous monitoring. Outcomes: The patient recovered well, and no signs of recurrence were detected during follow-up. Lessons: This case illustrates that mNGS, as an emerging molecular biological diagnostic technique, holds significant diagnostic value for the rapid identification of sporotrichosis. Timely and accurate diagnosis is essential for achieving favorable clinical outcomes.