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| {{DiseaseDisorder infobox | | | __NOTOC__ |
| Name = Sporotrichosis |
| | {{Sporotrichosis}} |
| Image = Feline sporotrichosis 4.jpg |
| | {{About1|Sporothrix schenckii}} |
| Caption = Cytologic preparation from a case of feline sporotrichosis; phagocytic cells show numerous variably-shaped yeast forms within |
| | '''For patient information on this page, click [[Sporotrichosis (patient information)|here]]''' |
| ICD10 = {{ICD10|B|42||b|35}} |
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| ICD9 = {{ICD9|117.1}} |
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| ICDO = |
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| OMIM = |
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| DiseasesDB = 29797 |
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| MedlinePlus = |
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| eMedicineSubj = med |
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| eMedicineTopic = 2161 |
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| eMedicine_mult = {{eMedicine2|derm|400}} |
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| MeshID = D013174 |
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| }}
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| {{SI}}
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| {{CMG}}
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| | {{CMG}}; {{AE}} {{AJL}}, {{JH}}. |
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| | {{SK}} Rose gardener's disease; Infection by ''Sporothrix schenckii'' |
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| '''Sporotrichosis''' is a disease caused by the infection of the [[fungus]] ''[[Sporothrix schenckii]]''.<ref name=Sherris>{{cite book | author = Ryan KJ, Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | pages = p. 654–6 | publisher = McGraw Hill | year = 2004 | isbn = 0838585299 }}</ref> This fungal disease usually affects the [[skin]], although other rare forms can affect the [[lung]]s, [[joint]]s, [[bone]]s, and even the [[brain]]. Because roses can spread the disease, it is one of a few diseases referred to as ''rose-thorn'' or ''rose-gardeners' disease''.<ref>{{cite web | author = Volk T | title = ''Sporothrix schenckii'', cause of Rose-picker's Disease | work = Tom Volk's Fungus of the Month | url = http://botit.botany.wisc.edu/toms_fungi/feb2003.html | accessdate = 2007-06-16}}</ref>
| | ==[[Sporotrichosis overview|Overview]]== |
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| Because ''S. schencki'' is naturally found in soil, [[hay]], [[sphagnum moss]], and plants, it usually affects [[farmer]]s, gardeners, and agricultural workers.<ref name=Sherris /> 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 historical perspective|Historical Perspective]]== |
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| 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]].
| | ==[[Sporotrichosis classification|Classification]]== |
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| ==Forms and symptoms of sporotrichosis== | | ==[[Sporotrichosis pathophysiology|Pathophysiology]]== |
| * ''Cutaneous or skin sporotrichosis''
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| :This is the most common form of this disease. Symptoms of this form includes nodular [[lesion]]s 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 [[ulceration|ulcer]] develops.
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| :Usually, cutaneous sporotrichosis lesions occur in the finger, hand, and arm.
| | ==[[Sporotrichosis causes|Causes]]== |
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| *''Pulmonary sporotrichosis''
| | ==[[Sporotrichosis differential diagnosis|Differentiating Sporotrichosis from other Diseases]]== |
| :This rare form of the disease occur when ''S. schenckii'' spores are inhaled. Symptoms of [[pulmonary]] sporotrichosis include productive [[cough]]ing, nodules and cavitations of the lungs, [[fibrosis]], and swollen [[hilar]] [[lymph node]]s. Patients with this form of sporotrichosis are susceptible to developing [[tuberculosis]] and [[pneumonia]]
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| *''Disseminated sporotrichosis''
| | ==[[Sporotrichosis epidemiology and demographics|Epidemiology and Demographics]]== |
| :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'').
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| :The symptoms of disseminated sporotrichosis include weight loss, [[anorexia (symptom)|anorexia]], and appearance of bony lesions.
| | ==[[Sporotrichosis risk factors|Risk Factors]]== |
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| ==Sporotrichosis in animals== | | ==[[Sporotrichosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| [[Image:Feline sporotrichosis 3.jpg|thumb|left|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. | |
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| ==Diagnosis== | | ==Diagnosis== |
| Sporotrichosis is a [[chronic (medicine)|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.
| | [[Sporotrichosis history and symptoms| History and Symptoms]] | [[Sporotrichosis physical examination | Physical Examination]] | [[Sporotrichosis laboratory findings|Laboratory Findings]] | [[Sporotrichosis chest x ray|Chest X Ray]] |
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| Patients with sporotrichosis will have [[antibodies|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]].
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| 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 variable in size, but many are cigar-shaped.
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| ==Prevention==
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| 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.
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| ==Treatment== | | ==Treatment== |
| Treatment of sporotrichosis depends on the severity and location of the disease. The following are treatment options for this condition:<ref>{{cite journal |author=Lortholary O, Denning DW, Dupont B |title=Endemic mycoses: a treatment update |journal=J. Antimicrob. Chemother. |volume=43 |issue=3 |pages=321-31 |year=1999 |pmid=10223586 |url=http://jac.oxfordjournals.org/cgi/content/full/43/3/321}}</ref>
| | [[Sporotrichosis medical therapy|Medical Therapy]] | [[Sporotrichosis surgery|Surgery]] | [[Sporotrichosis primary prevention|Primary Prevention]] | [[Sporotrichosis secondary prevention|Secondary Prevention]] |
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| *Saturated [[potassium iodide]] solution
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| :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.
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| *[[Itraconazole]] (Sporanox) and [[fluconazole]]
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| :These are [[antifungal]] drugs. Itraconazole are the preferred medicine, although patients that cannot tolerate it can be given fluconazole.
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| *[[Amphotericin B]]
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| :This antifungal medication is delivered intravenously. Many patients, however, cannot tolerate Amphotericin B due to its potential side effects of fever, nausea, and vomiting.
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| :In case of sporotrichosis meningitis, the patient may be given a combination of Amphotericin B and [[5-fluorocytosine]].
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| *[[Surgery]]
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| :In cases of bone infection and cavitatory nodules in the lungs, surgery may be necessary.
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| ==Complications==
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| Sporotrichosis can develop into other diseases, including [[cellulitis]], [[sarcoidosis]], and [[tuberculosis]]. | |
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| ==References==
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| {{Reflist}}
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| ==External links==
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| * [http://www.healthinplainenglish.com/health/infectious_diseases/sporotrichosis/index.htm Sporotrichosis] by Health in Plain English (with pictures)
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| * [http://www.cdc.gov/ncidod/dbmd/diseaseinfo/sporotrichosis_g.htm Sporotrichosis] by Centers for Disease Control and Prevention (CDC)
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| {{Mycoses}}
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| [[Category:Fungal diseases]]
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| [[es:Esporotricosis]]
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| [[zh:孢子絲菌病]]
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| {{WH}}
| | ==Case Studies== |
| {{WS}}
| | [[Sporotrichosis case study one|Case#1]] |