PMC6020502_01
MRI (axial view) of left knee showing synovial thickening (arrow).
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MRI of his left knee also demonstrated a joint effusion with a popliteal cyst and synovial thickening (Figure 1).
A hyphal form of Sporothrix schenkii from synovial fluid aspirate cultured on Sabouraud agar. Narrow branching hyphae (red arrows) giving rise to slender conidiophores (white arrows) at right angles. The apex of conidiophores is covered with tear-shaped conidia in a rosette-like fashion (black arrows). Single conidia can also be formed along the hyphae.
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Bacterial culture did not demonstrate any growth, but fungal cultures grew branching narrow hyphae with septations and conidia in a bouquet-like appearance leading to a presumptive diagnosis of Sporothrix schenkii (Figure 2).
Histopathologic features of excisional biopsy. H/E-stained sections demonstrate mixed chronic inflammation composed of plasma cells and lymphocytes. Scattered granulomas are present with central necrosis (x200).
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GMS stain was negative for fungal organisms (Figure 3).