Sporotrichosis

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**Sporotrichosis**
*Classifications and external resources*
ICD-10	B 42.
ICD-9	117.1
DiseasesDB	29797

Sporotrichosis is a disease caused by the infection of the fungus Sporothrix schenckii. This fungal disease usually affects the skin, although other rare forms can affect the lungs, joints, bones, and even the brain.

Because S. schencki is naturally found in soil, hay, sphagnum moss, and plants, it usually affects farmers, gardeners, and agricultural workers. It enters through small cuts and abrasions in the skin to cause the infection. In case of sporotrichosis affecting the lungs, the fungal spores enter through the respiratory pathways. Sporotrichosis can also be acquired from handling cats with the disease; it is an occupational hazard for veterinarians.

Sporotrichosis progresses slowly - the first symptoms may appear 1 to 12 weeks (average 3 weeks) after the initial exposure to the fungus. Serious complications can also develop in patients who have a compromised immune system.

1 Forms and symptoms of sporotrichosis
2 Sporotrichosis in animals
3 Diagnosis
4 Prevention
5 Treatment
6 Complications
7 External links

[edit] Forms and symptoms of sporotrichosis

Cutaneous or skin sporotrichosis

This is the most common form of this disease. Symptoms of this form includes nodular lesions or bumps in the skin, at the point of entry and also along lymph nodes and vessels. The lesion starts off small and painless, and ranges in color from pink to purple. Left untreated, the lesion becomes larger and look similar to a boil and more lesions will appear, until a chronic ulcer develops.

Usually, cutaneous sporotrichosis lesions occur in the finger, hand, and arm.

Pulmonary sporotrichosis

This rare form of the disease occur when S. schenckii spores are inhaled. Symptoms of pulmonary sporotrichosis include productive coughing, nodules and cavitations of the lungs, fibrosis, and swollen hilar lymph nodes. Patients with this form of sporotrichosis are prone to develop tuberculosis and pneumonia

Disseminated sporotrichosis

When the infection spreads from the primary site to secondary sites in the body, the disease develops into a rare and critical form called disseminated sporotrichosis. The infection can spread to joints and bones (called osteoarticular sporotrichosis) as well as the central nervous system and the brain (called sporotrichosis meningitis).

The symptoms of disseminated sporotrichosis include weight loss, anorexia, and appearance of bony lesions.

[edit] Sporotrichosis in animals

Ulcerative skin disease in a cat with Sporotrichosis; a cat with this disease must be handled with caution as this form can be contagious to other animals and to man

Sporotrichosis can be diagnosed in domestic and wild mammals. In veterinary medicine it is most frequenttly seen in cats and horses. Cats have a particularly severe form of cutaneous sporotrichosis and also can serve as a source of zoonotic infection to persons who handle them and are exposed to exudate from skin lesions.

[edit] Diagnosis

Cytologic preparation from a case of feline sporotrichosis; phagocytic cells show numerous variably-shaped yeast forms within

Sporotrichosis is a chronic disease with slow progression and often subtle symptoms. It is difficult to diagnose, as many other diseases share similar symptoms and therefore must be ruled out.

Patients with sporotrichosis will have antibody against the fungus S. schenckii, however, due to variability in sensitivity and specificity, it may not be a reliable diagnosis for this disease. The confirming diagnosis remains culturing the fungus from the skin, sputum, synovial fluid, and cerebrospinal fluid.

Cats with sporotrichosis are unique in that the exudate from their lesions may contain numerous organisms. This makes cytological evaluation of exudate a valuable diagnostic tool in this species. Exudate is pyogranulomatous and phagocytic cells may be packed with yeast forms. These are are variable in size, but many are cigar-shaped.

[edit] Prevention

The majority of sporotrichosis cases occur when the fungus is introduced through a cut or puncture in the skin while handling vegetations containing the fungal spores. Prevention of this disease includes wearing long sleeves and gloves while working with soil, hay bales, rose bushes, pine seedlings, and sphagnum moss.

[edit] Treatment

Treatment of sporotrichosis depends on the severity and location of the disease. The following are treatment options for this condition:

Saturated potassium iodide solution

Although its mechanism is unknown, oral application of potassium iodide in droplet form can cure cutaneous sporotrichosis. This usually requires 3 to 6 months of treatment.

Itraconazole (Sporanox) and fluconazole

These are antifungal drugs. Itraconazole are the preferred medicine, although patients that cannot tolerate it can be given fluconazole.

Amphotericin B

This antifungal medication is delivered intravenously. Many patients, however, cannot tolerate Amphotericin B due to its potential side effects of fever, nausea, and vomiting.

In case of sporotrichosis meningitis, the patient may be given a combination of Amphotericin B and 5-fluorocytosine.