COVID-19-INDUCED REACTIVATION OF SPOROTRICHOSIS LEADING TO RAY AMPUTATION: A RARE CASE REPORT

Sporotrichosis is an infection caused by the dimorphic fungus Sporothrix schenckii, acquired through contamination of the wound by the fungi. While cutaneous forms are most common, osteoarticular involvement is rare and usually seen in immunocompromised individuals. We present a case of chronic monoarthritis of the proximal interphalangeal joint in a 36-year-old immunocompetent nurse, previously treated with itraconazole after fungal culture confirmed Sporothrix schenckii infection. Following a COVID-19 infection, the patient experienced recurrence of the arthritis, with progressive joint destruction despite ongoing antifungal therapy. Surgical debridement was performed, but worsening symptoms ultimately necessitated ray amputation of the affected digit. Postoperatively, the patient regained good hand function with minimal limitations and reported an improved quality of life at 1-year follow-up. This case highlights the diagnostic challenges of osteoarticular sporotrichosis, the potential for COVID-19 to induce reactivation of latent fungal infections through immune dysregulation, and the importance of a multimodal approach including surgery in refractory cases to preserve function.