Sporotrichosis (patient information)
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Sporotrichosis |
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Sporotrichosis On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alison Leibowitz [2]
Overview
Sporotrichosis is a long-term (chronic) skin infection that is caused by a fungus called Sporothrix schenckii
What are the symptoms of Sporotrichosis?
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 lesions are on the hands and forearms, because these areas are commonly injured when handling plants. In children, lesions may be more likely to manifest on the face.
The fungus may follow the channels in your body's lymphatic 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.
What causes Sporotrichosis?
Sporothrix schenckii is found in plants. Infection commonly occurs when the skin is broken while handling plant materials 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.
Who is at highest risk?
People who handle thorny plants, sphagnum moss, or bales of hay are at increased risk of getting sporotrichosis. The infection is more common among people with weakened immune systems, but it can also occur in otherwise healthy people. Outbreaks have occurred among florists, plant nursery workers who have handled sphagnum moss, rose gardeners, children who have played on bales of hay, and greenhouse workers who have handled thorns contaminated by the fungus.
Diagnosis
Sporotrichosis is typically diagnosed when your doctor obtains a swab or a biopsy of the infected site and sends the sample to a laboratory for a fungal culture. Serological tests are not always useful in the diagnosis of sporotrichosis due to limitations in sensitivity and specificity.
Treatment options
The skin infection is usually 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 body-wide (systemic) disease can last up to 12 months.
Where to find medical care for Sporotrichosis?
Make an appointment with your health care provider if you develop persistent skin lumps or skin ulcers. Tell your health care provider if have been working with plants or plant based materials, particularly thorny plants, such as roses.
What to expect (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 normal 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 medications -- amphotericin B can have serious side effects
- Lung and breathing problems (such as pneumonia)
- Meningitis
- Widespread (disseminated) disease
Prevention of Sporotrichosis
People with a weakened immune system should try to reduce risk of skin injury. Wearing thick gloves while gardening can help.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/001338.htm