Spontaneous Regression of Cardiomyopathy in a Patient with the Acquired Immunodeficiency Syndrome

Abstract

Sporotrichosis is a chronic skin infection caused by the demorphic fungus Sporothrix schenckii. I have been unable to find a documented case of sporotrichosis that underwent spontaneous cure and, therefore, am reporting the following case of sporotrichosis of the nose that spontaneously resolved.

Case Details

Personal Characteristics

32-year-old woman, history of intravenous cocaine and heroin abuse

Clinical Characteristics

Peripheral edema, abdominal fullness, dyspnea, marked jugular venous distention with prominent v waves, right ventricular heave, summation gallop, grade 2/6 pansystolic murmur over the xyphoid with inspiratory augmentation, pulsatile hepatomegaly, 2+ bipedal edema, biventricular dilation with generalized hypokinesis, paradoxic septal motion, small pericardial effusion, pulmonic and tricuspid insufficiency, left ventricular dysfunction, pulmonary hypertension, low cardiac output

Remission Characteristics

Resolution of the abnormal cardiopulmonary findings and roentgenographic cardiomegaly, improvement in biventricular wall motion with resolution of the valvular insufficiencies, normal coronary arteries and only mild inferior hypokinesis, cardiac output and pulmonary and systemic hypertension had markedly improved

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Routine treatment of congestive heart failure, right heart catheterization with endomyocardial biopsy, regimen of vasodilators, diuretics, and digitalis, zidovudine (azidothymidine [azt]) therapy

Additional Notes

Zidovudine (azidothymidine [AZT]) therapy was discontinued due to neutropenia. From January through March 1989, the patient was incarcerated in another state where treatment with all medication was discontinued.