Sporotrichosis

Sporotrichosis is a disease caused by the infection of the fungus Sporothrix schenckii (S. schenckii). This fungal disease usually affects the skin, although other rare forms can affect the lungs, joints, bones, and even the brain. more...

Because S. schencki is naturally found in soil, hay, sphagnum moss, and plants, it usually affects farmers, gardeners, and agricultural workers. 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 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.

Forms and symptoms of sporotrichosis

• Cutaneous or skin sporotrichosis

This is the most common form of this disease. Symptoms of this form includes nodular lesions 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 ulcer develops.

Usually, cutaneous sporotrichosis lesions occur in the finger, hand, and arm.

• Pulmonary sporotrichosis

This rare form of the disease occur when S. schenckii spores are inhaled. Symptoms of pulmonary sporotrichosis include productive coughing, nodules and cavitations of the lungs, fibrosis, and swollen hilar lymphs. Patients with this form of sporotrichosis are prone to develop tuberculosis and pneumonia

• Disseminated sporotrichosis

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).

The symptoms of disseminated sporotrichosis include weight loss, anorexia, and appearance of bony lesions.

Diagnosis

Sporotrichosis is a 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.

Patients with sporotrichosis will have 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.

Prevention

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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