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Sporotrichosis

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Illustrations

Sporotrichosis on the hand and arm
Sporotrichosis on the hand and arm
Sporotrichosis on the arm
Sporotrichosis on the arm
Sporotrichosis on the forearm
Sporotrichosis on the forearm

Definition    Return to top

Sporotrichosis is a chronic skin infection, caused by a fungus which may become a widespread (disseminated, systemic) infection, particularly in people with weakened immune systems.

Causes, incidence, and risk factors    Return to top

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 include a small, painless, red lump that develops at the site of infection and ultimately develops into an ulcer. Lesions are often on the hands and forearm, as these areas are a common site of injury.

The organism follows the lymph flow causing small ulcers to appear in lines on the skin as the infection progresses up the arm (or leg). These lesions do not heal unless treated and may remain ulcerated for years.

Systemic sporotrichosis can cause lung and breathing problems, osteomyelitis, arthritis, and meningitis.

Symptoms    Return to top

Signs and tests    Return to top

A physical examination reveals the typical lesions. A culture of biopsied tissue that demonstrates Sporothrix schenckii confirms the diagnosis.

Treatment    Return to top

The skin infection is usually treated with potassium iodide (for example, SSKI) given by mouth 3 times per day or itraconazole by mouth. Treatment is prolonged and continues 1 month after the skin lesions clear. Systemic or disseminated infection is often treated with Amphotericin B, or sometimes itraconazole.

Expectations (prognosis)    Return to top

With treatment, full recovery can be expected. Disseminated sporotrichosis is more difficult to treat and requires chemotherapeutic agents. Disseminated sporotrichosis can be life-threatening for immunocompromised people.

Complications    Return to top

In people with a normal immune system: In people who are immunosuppressed:

Calling your health care provider    Return to top

Call for an appointment with your health care provider if you develop persistent skin lumps or skin ulcers. If you know that you have been exposed to vegetation, mention this to your health care provider.

Prevention    Return to top

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.

Update Date: 7/16/2004

Updated by: Daniel Levy, M.D., Ph.D., Infectious Diseases, Greater Baltimore Medical Center, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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