Sporotrichosis

Background

Also known as "Rose gardener's disease"^[1]
Caused by the fungus Sporothrix schenckii^[2] found on rose thorns
Usually affects skin, although other rare forms can affect the lungs, joints, bones, and brain
Enters skin through small cuts and abrasions, and inhalation for pulmonary disease
Can also be acquired from handling cats with the disease

Progresses slowly: first symptoms may appear 1 to 12 weeks (average 3 weeks) after the initial exposure to the fungus

Cutaneous or skin
- Most common form
- Symptoms include nodular lesions or bumps in the skin, at the point of entry and also along lymph nodes and vessels
  - Lesion starts off small and painless, and ranges in color from pink to purple
  - Left untreated, lesion becomes larger and looks similar to an abscess. More lesions will appear until a chronic ulcer develops
Pulmonary sporotrichosis
- Rare
- From inhalation of spores
- Symptoms include productive coughing, nodules and cavitations of the lungs, fibrosis, and hilar lymphadenopathy nodes
- May become superinfected with pneumonia or tuberculosis
Disseminated sporotrichosis
- May affect joints and bones (osteoarticular sporotrichosis) and or CNS (sporotrichosis meningitis)
- Symptoms include weight loss, anorexia, and appearance of bony lesions

Fungal culture of skin, sputum, synovial fluid, or CSF

Antifungal medication
- Itraconazole
  - Drug of choice (more effective than fluconazole)
- Fluconazole
  - Fluconazole (for patients who cannot tolerate itraconazole)
- Amphotericin B IV
  - For disseminated of severe disease
Surgery
- For osteomyelitis or cavitatory nodules in the lungs
Standard antibiotics
- Lesions sometimes become superinfected, consider as necessary

↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
↑ Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed.). McGraw Hill. pp. 654–6. ISBN 0-8385-8529-9.