Sporotrichosis

Sporotrichosis is a chronic fungal disease that results from inoculation into the subcutaneous tissue through minor trauma. Plant nursery workers, florists, and gardeners can acquire it from roses, sphagnum moss, and other plants. Plague sporotrichosis is limited to the site of the infection, and lymphangitis sporotrichosis occurs when the infection spreads along proximal lymph channels. Spread beyond the extremity is rare. Osteoarticular, pulmonary, and other extracutaneous forms are likely to evolve from the lung.

Causes

Sporotrichosis is caused by the fungus Sporothrix schenckii, which is found in vegetation. Infection commonly occurs when the skin is broken while handling plant materials such as rosebushes, briars, or mulch-rich dirt.

Sporotrichosis can be an occupational disease (for farmers, horticulturists, rose gardeners, plant nursery workers). Widespread (disseminated) sporotrichosis can develop in immunocompromised people when they inhale spore-laden dust.

Symptoms and Signs

• Once the mold spores move into the skin, the disease takes days-to-months to develop.
• The first symptom is a firm bump (nodule) on the skin that can range in color from pink to nearly purple. The nodule is usually painless or only mildly tender.
• The nodule may develop an open sore (ulcer) that may drain clear fluid.
• Untreated, the nodule and the ulcer become chronic and may remain unchanged for years.
• In very rare cases, the infection can spread to other parts of the body.
  
  
  • The disease can infect the bones, joints, lungs, and brain.
  • Such spreading usually occurs only in people with a weakened immune system.
  • These infections can be life threatening and are difficult to treat.

Diagnostic tests

Culture of S. schenckii in sputum, pus, or bone drainage confirms the diagnosis. Histologic identification is difficult. Despite pulmonary symptoms, few definitive abnormalities appear on a chest X-ray.

Demineralization of bone is evident on X-ray for osteoarticular sporotrichosis. Draining sinuses appear over joints and lesions. Pulmonary sporotrichosis presents as a single, chronic, cavitary lesion of the upper lobe of the lung. S. schenckii is difficult to obtain from cerebrospinal fluid.

Treatment

The cutaneous lymphatic form of the disease usually responds to application of a saturated solution of potassium iodide, usually continued for 1 month after lesions heal. The extracutaneous form responds to I.V amphortericin B but may requires several weeks of treatment.

Prevention

Safer sex behavior can help prevent infection with HIV, the virus that causes AIDS. People with compromised immune systems should try to minimize exposure by taking measures like wearing thick gloves while gardening.

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