Sporotrichosis is infection caused by the fungus Sporothrix schenckii.

• The infection develops when the fungi enter the body through a puncture wound.
• Usually, the skin and lymph nodes are infected, resulting in bumps on the skin and swollen lymph nodes.
• Rarely, the lungs, joints, or other parts of the body are infected.
• Diagnosis requires culture and identification of the fungus in a sample of infected tissue.
• ItraconazoleSome Trade Names
  SPORANOX
  is used to treat most infections, but amphotericin BSome Trade Names
  FUNGIZONE
  is required for bodywide infections.

Sporothrix fungi typically grow on rosebushes, barberry bushes, sphagnum moss, and other mulches. In contrast to many other fungal infections, Sporothrix fungi enter the body through a puncture wound to the skin. Most often, farmers, gardeners, and horticulturists are infected.

Sporotrichosis affects mainly the skin and nearby lymphatic vessels. Very rarely, bones, joints, lungs, or other tissues are infected.

Symptoms and Diagnosis

An infection of the skin typically starts on a finger as a small, nontender bump (nodule) that slowly enlarges and forms a sore. Over the next several days or weeks, the infection spreads through the lymphatic vessels of the finger, hand, and arm to the lymph nodes, forming nodules and sores along the way. Even at this stage, there is little or no pain. Usually, people have no other symptoms. This infection is seldom fatal.

An infection in the lungs may cause pneumonia, with a slight chest pain and cough. Lung infection usually occurs in people who have another lung disorder, such as emphysema. Joint infection causes swelling and makes movement painful. Rarely, an infection develops in other areas and can spread throughout the body. Such infections are life threatening.

The characteristic nodules and sores may lead a doctor to suspect sporotrichosis. The diagnosis is confirmed by growing (culturing) and identifying Sporothrix in samples of infected tissue.

Treatment

Skin infections are treated with itraconazoleSome Trade Names
SPORANOX
given by mouth. Potassium iodideSome Trade Names
THYROSAFE
, given by mouth, may be prescribed instead, but it is not as effective and, in most people, has side effects (such as a rash, a runny nose, and inflammation of the eyes, mouth, and throat).

Lung and bone infections may also be treated with itraconazoleSome Trade Names
SPORANOX
. For bodywide infections, amphotericin BSome Trade Names
FUNGIZONE
is given intravenously.

Last full review/revision October 2008 by Alan M. Sugar, MD