Sporotrichosis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Alison Leibowitz [2]
Overview
Natural History
- The incubation period of sporotrichosis varies from a few days to multiple months. [1]
Complications
- Cutaneous lesions can become superinfected with bacteria, resulting in cellulitis.
- Potassium iodide, which is typically the first line of treatment, has potential side effects of gastric intolerance, edema, salivary gland swelling, skin rash, and erythema nodosum.
- 5-fluorocytosine therapy may result in photosensitivity[2]
Prognosis
- S. schenckii is an apparent opportunistic pathogen, as severe clinical forms of this disease have been linked with immunodeficient patients.
- Resistance to S. schenckii is not linked to the host’s inherent ability to fight the fungal infection, but rather results from the level of immunity that the host acquires during the initial stage, which is characterized by a large pathogen presence within the organs.[3]
- Resultantly, depending on the host's immune system capacity (T-cell immunity is important in limiting the disease) at the time of diagnosis, the prognosis may vary.
- In immunocompetent patients, the prognosis for cutaneous and lymphocutaneous sporotrichosis is excellent. The majority of these patients are cured with one bout of therapy and relapses only occur in a low percentage of patients.
- The prognosis for disseminated sporotrichosis in immunocompromised patients is particularly poor.
References
- ↑ Vásquez-del-Mercado E, Arenas R, Padilla-Desgarenes C. Sporotrichosis. Clinics in Dermatology. 2012;30(4):437-443. doi:10.1016/j.clindermatol.2011.09.017.
- ↑ Shelley WB, Sica PA (1983). "Disseminate sporotrichosis of skin and bone cured with 5-fluorocytosine: Photosensitivity as a complication". J Am Acad Dermatol. 8 (2): 229–35. PMID 6826816.
- ↑ Nascimento RC, Almeida SR (2005). "Humoral immune response against soluble and fractionate antigens in experimental sporotrichosis". FEMS Immunol Med Microbiol. 43 (2): 241–7. doi:10.1016/j.femsim.2004.08.004. PMID 15681154.