Sporotrichosis pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Alison Leibowitz [2]

Pathophysiology

Transmission

• S. schenckii is usually transmitted to the human host via posttraumatic inoculation. However, sporotrichosis may also develop as a result of spore inhalation, although this mode of transmission is infrequent.
• Modes of transmission either lead to direct inoculation or enable the entry of the fungus.

• Actions, such as handling thorny plants, sphagnum moss, bales of hay, or any plant or plant product that can cause skin trauma, may enable S. schenckii entry.

Pathogenesis

• The pathophysiology of sporotrichosis depends on the histological subtype and the frequently nonspecific histopathology may mimic other granulomatous diseases.

Cutaneous forms

• S. schecknii accesses the subcutaneous tissue following minor epidermal trauma.
• S. schecknii, a thermo-dependent fungus, converts into its yeast form upon entering the tissue.

• Fixed form
  • The yeast form of S. schenckii stays localized in subcutaneous tissue
• Lymphocutaneous form
  • The yeast form of S. schenckii extends through the nearby lymphatic vessels
• Disseminated cutaneous form
  • Manifests upon the hematogenous dissemination of the yeast form of S. schenckii.

Extracutaneous/Systematic Forms

• Osteoarticular form
  • May manifest upon contiguity or hematogenous spread.
• Pulmonary form
• Disseminated form