Abstract: A 53-year-old female patient presented with multiple red nodules, plaques and ulcers on her upper arm for 4 months. She was first diagnosed with “lipoma” in the surgery department and underwent resection of the lesions. Pathological examination of the resected specimen showed chronic inflammation. Two weeks after the operation, red nodules with ulcers appeared in the surgical area, which persisted for 4 months without healing. Then, she consulted the dermatology department, and the histopathology of the re-excised new lesion showed infectious granuloma. Sporothrix globosa was identified by fungal culture and m-NGS high-throughput sequencing. Additional PAS staining of the first surgical resection specimen from the surgery department revealed a small number of fungal spores. The patient was given oral itraconazole capsules for treatment, and the lesions improved significantly after 3 months, and the treatment is still ongoing. This case suggests that early sporotrichosis is easily misdiagnosed, and mycological examinations should be performed as early as possible for persistent postoperative inflammation or ulcers to avoid missed diagnosis and delay in treatment.

Key words: sporotrichosis, Sporothrix globosa, cutaneous infection, lipoma