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Sporotrichosis

 

Sporotrichosis is a long-term (chronic) skin infection that is caused by a fungus called Sporothrix schenckii.

Causes

Sporothrix schenckii is found in plants. Infection commonly occurs when the skin is broken while handling plant material such as rosebushes, briars, or dirt that contains a lot of mulch.

Sporotrichosis can be a job-related disease for people who work with plants, such as farmers, horticulturists, rose gardeners, and plant nursery workers. Widespread (disseminated) sporotrichosis can develop in people with a weakened immune system when they inhale dust filled with spores of the fungus.

Symptoms

 

Symptoms include a small, painless, red lump that develops at the site of infection. As time passes, this lump will turn into an ulcer (sore). The lump may develop up to 3 months after an injury.

Most sores are on the hands and forearms because these areas are commonly injured when handling plants.

The fungus follows the channels in your body's lymph system. Small ulcers appear as lines on the skin as the infection moves up an arm or leg. These sores do not heal unless they are treated, and they may last for years. The sores may sometimes drain small amounts of pus.

Body-wide (systemic) sporotrichosis can cause lung and breathing problems, bone infection, arthritis, and infection of the nervous system.

 

Exams and Tests

 

A physical examination will show the typical sores caused by the fungus. Sometimes, a small sample of affected tissue is removed, examined under a microscope, and tested in a lab to identify the fungus.

 

Treatment

 

The skin infection is often treated with an antifungal medicine called itraconazole. It is taken by mouth and continued for 2 to 4 weeks after the skin sores have cleared. You may have to take the medicine for 3 to 6 months. A medicine called terbinafine may be used instead of itraconazole.

Infections that have spread or affect the entire body are often treated with amphotericin B, or sometimes itraconazole. Therapy for systemic disease can last up to 12 months.

 

Outlook (Prognosis)

 

With treatment, full recovery is likely. Disseminated sporotrichosis is more difficult to treat and requires several months of therapy. Disseminated sporotrichosis can be life-threatening for people with a weakened immune system.

 

Possible Complications

 

People with a healthy immune system may have:

  • Discomfort
  • Secondary skin infections (such as staph or strep)

People with a weakened immune system may develop:

  • Arthritis
  • Bone infection
  • Complications from medicines -- amphotericin B can have serious side effects
  • Lung and breathing problems (such as pneumonia)
  • Brain infection (meningitis)
  • Widespread (disseminated) disease

 

When to Contact a Medical Professional

 

Make an appointment with your health care provider if you develop persistent skin lumps or skin ulcers that do not go away. Tell your provider if you know that you were exposed to plants from gardening.

 

Prevention

 

People with a weakened immune system should try to reduce risk for skin injury. Wearing thick gloves while gardening can help.

 

 

References

Hsu LY, Wijaya L, Shu-Ting E, Gotuzzo E. Tropical fungal infections. Infec Dis Clin N Am. June 2012;26(2):497-512. PMID: 22632651 www.ncbi.nlm.nih.gov/pubmed/22632651.

Kauffman CA. Sporotrichosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 337.

Rex JH, Okhuysen PC. Sporothrix schenckii. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 261.

 
  • Sporotrichosis on the hand and arm

    Sporotrichosis on the hand and arm - illustration

    Sporotrichosis is a fungal infection that frequently occurs following a minor injury while gardening or farming. Spores, which live in vegetation, enter the skin and begin to grow. The fungus follows the lymph channels up the extremity. Granulomatous lesions develop along the lymph channel, ulcerate, and drain. If left untreated, this condition can persist for years.

    Sporotrichosis on the hand and arm

    illustration

  • Sporotrichosis on the arm

    Sporotrichosis on the arm - illustration

    Sporotrichosis is a fungal infection that frequently occurs following a minor injury while gardening or farming. Spores, which live in vegetation, enter the skin and begin to grow. The fungus follows the lymph channels up the extremity. Granulomatous lesions develop along the lymph channel, ulcerate, and drain. If left untreated, this condition can persist for years.

    Sporotrichosis on the arm

    illustration

  • Sporotrichosis on the forearm

    Sporotrichosis on the forearm - illustration

    Sporotrichosis is a fungal infection that frequently occurs following a minor injury while gardening or farming. Spores, which live in vegetation, enter the skin and begin to grow. The fungus follows the lymph channels up the extremity. Granulomatous lesions develop along the lymph channel, ulcerate, and drain. If left untreated, this condition can persist for years.

    Sporotrichosis on the forearm

    illustration

    • Sporotrichosis on the hand and arm

      Sporotrichosis on the hand and arm - illustration

      Sporotrichosis is a fungal infection that frequently occurs following a minor injury while gardening or farming. Spores, which live in vegetation, enter the skin and begin to grow. The fungus follows the lymph channels up the extremity. Granulomatous lesions develop along the lymph channel, ulcerate, and drain. If left untreated, this condition can persist for years.

      Sporotrichosis on the hand and arm

      illustration

    • Sporotrichosis on the arm

      Sporotrichosis on the arm - illustration

      Sporotrichosis is a fungal infection that frequently occurs following a minor injury while gardening or farming. Spores, which live in vegetation, enter the skin and begin to grow. The fungus follows the lymph channels up the extremity. Granulomatous lesions develop along the lymph channel, ulcerate, and drain. If left untreated, this condition can persist for years.

      Sporotrichosis on the arm

      illustration

    • Sporotrichosis on the forearm

      Sporotrichosis on the forearm - illustration

      Sporotrichosis is a fungal infection that frequently occurs following a minor injury while gardening or farming. Spores, which live in vegetation, enter the skin and begin to grow. The fungus follows the lymph channels up the extremity. Granulomatous lesions develop along the lymph channel, ulcerate, and drain. If left untreated, this condition can persist for years.

      Sporotrichosis on the forearm

      illustration


     

    Review Date: 3/13/2016

    Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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