Sporotrichosis

<B>Sporotrichosis:</B> An infection most commonly of the skin caused by the fungus <I>Sporothrix schenckii</I>.

Persons handling thorny plants, sphagnum moss, or baled hay are at increased risk of developing sporotrichosis.

Outbreaks of sporotrichosis have occurred among nursery workers handling sphagnum moss, rose gardeners, children playing on baled hay, and greenhouse workers handling bayberry thorns that are contaminated by the fungus.

A number of cases have recently occurred among nursery workers, especially workers handling sphagnum moss topiaries.

The fungus is found in sphagnum moss, in hay, in other plant materials, and in the soil.

It enters the skin through small cuts or punctures from thorns, barbs, pine needles, or wires.

Less often, the fungus may be inhaled into the lungs.

The disease cannot be spread from one person to another.

The first sign of sporotrichosis is usually a small painless bump resembling an insect bite.

It can be red, pink, or purple in color.

The bump (nodule) usually appears on the finger, hand, or arm where the fungus first entered through a break on the skin.

This is followed by one or more additional bumps or nodules which open.

They may look like boils.

Eventually, the bumps turn into open hollowed-out sores (ulcerations), which are very slow to heal.

The infection can also spread to other areas of the body.

The large majority of infections with sporotrichosis are limited to the skin (localized).

Sporotrichosis infection can spread through the blood to other areas (disseminated), but this is relatively rare.

For example, infection of the joints, lungs, eye, and the genitourinary and central nervous system (brain and spine) can result.

Usually, disseminated sporotrichosis occurs in people who have problems with the immune system; for example, persons with AIDS (acquired immunodeficiency syndrome), cancer, patients undergoing chemotherapy, and transplant recipients on immunosuppressive therapy.

Symptoms vary greatly from patient to patient.

The nodules are usually visible within 3 weeks after the fungus enters the skin, but then the first nodule can appear any time from 1 to 12 weeks (3 months) later.

Sporotrichosis is confirmed by obtaining a swab or a biopsy of a freshly opened skin nodule and submitting it to a laboratory for examination.

A fungal culture is then used to detect the fungus <I>Sporothrix schenckii</I>.

Sporotrichosis is treated with potassium iodide, taken by mouth in droplet form.

A new drug, called itraconazole (SPORANOX), is also available for the treatment of sporotrichosis, but experience with this drug is still limited.

Treatment, whether it be with potassium iodide or itraconazole (SPORANOX), should be extended for a number of weeks until all of the skin abnormalities are completely healed.

Measures to prevent sporotrichosis include wearing gloves and long sleeves when handling wires, rose bushes, hay bales, pine seedlings, or other materials that may cause minor skin breaks.

It is also advisable to avoid skin contact with sphagnum moss, a common source of the fungus <I>Sporothrix schenckii</I>, the cause of sporotrichosis.