Causes and Risks:

Sporotrichosis is caused by the fungus Sporothrix schenckii which is found in vegetation. It is usually inoculated into the skin when the skin is broken while handling plant materials such as rosebushes, briars, or mulch-rich dirt.

Sporotrichosis can be an occupational disease (for farmers, horticulturists, etc.). Widespread (disseminated) sporotrichosis develops in immunocompromised people when they inhale spore-laden dust.

Symptoms include a small, painless, red lump that develops at the site of inoculation and ultimately develops into an ulcer. Lesions are often on the hands and forearm (as these areas are a common site of injury).

The organism follows the lymph flow causing small ulcers to appear in lines on the skin as the infection progresses up the arm (or leg). These lesions do not heal unless treated and may remain ulcerated for years.

Systemic sporotrichosis can cause lung and breathing problems, osteomyelitis, arthritis, and meningitis.

Prevention: Prevention of this disease is impractical as the fungus Sporothrix schenckii is distributed worldwide and associated with vegetation (living, dead, or in a state of decomposition). Immunocompromised individuals should limit their exposure as much as possible.

Symptoms:

• Small, painless, red lump that develops at site of a recent injury (up to 3 months following injury).
• A progressive line of ulcers leading away from the initial ulcer.

Signs and Tests: A physical examination reveals the typical lesions. A culture of biopsied tissue that demonstrates Sporothrix schenckii confirms the diagnosis.

Treatment: The skin infection is usually treated with potassium iodide (for example, SSKI) given by mouth 3 times per day or itraconazole by mouth. Treatment is prolonged and continues 1 month after the skin lesions clear. Systemic or disseminated infection is often treated with Amphotericin B, or sometimes intraconazole.

Prognosis: With treatment, full recovery can be expected. Disseminated sporotrichosis is more difficult to treat and requires chemotherapeutic agents. Disseminated sporotrichosis can be life-threatening for immunocompromised people.

Complications: In people with a normal immune system:

• Secondary skin infections
• Discomfort

• Disseminated disease
• Lung and breathing problems (such as pneumonia)
• Osteomyelitis
• Arthritis
• Meningitis

Call for an appointment with your health care provider if you develop persistent skin lumps or skin ulcers. If you know that you have been exposed to vegetation, mention this to your health care provider.