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Osteoarticular sporotrichosis was diagnosed in a dog referred for evaluation of hindlimb lameness. There was radiographic evidence of osteopenia of the fourth tarsal and proximal aspects of the metatarsal bones. The diagnosis was based on histologic findings and results of physical examination, radiography, fungal culturing, and serologic tests. The dog was treated successfully with ketoconazole for 3 1/2 months.
Sporotrichosis is not an uncommon disease. Lymphocutaneous involvement is the common characteristic but systemic dissemination from the primary skin lesion has been observed. The disease is progressive but spontaneous resolution, in rare instances, has been observed. Multiple, fungating, ulcerated, tumorous cutaneous lesions, fixed to the underlying tissue, often pose a difficult diagnostic problem, as in this case. The disease has been frequently related to occupational exposure to plant life, but handling of infected animals may be a source of infection in rare instances.
The Transvaal was once known as an area with a high incidence of sporotrichosis in workers on the goldmines. The nature of the infection was not understood before the disease was first clinically identified 60 years ago by the pathologist, Dr B. D. Pullinger. Working with Dr A. Pijper in Pretoria, she demonstrated the presence of a pathogenic Sporothrix fungus. Now in retirement, Dr Pullinger has told how this discovery was made.
A small familial epidemic of cutaneous sporotrichosis occurring in North Texas is reported. The disease occurred in four out of six children in two separate families of paternal cousins. The presumed source of infection was old prairie hay used for mulching. Trauma at the time of exposure seemed minimal or absent. Response to oral potassium iodide therapy was prompt and satisfactory.
The diagnosis of primary pulmonary sporotrichosis was made in a 53-year-old male alcoholic four years after initial presentation with cavitary lung disease. Clinical and radiologic awareness of this extremely rare entity will allow optimal study of bronchial secretions in the bacteriology laboratory. Important clues include: (1) exposure to thorny plants, (2) cavitary pulmonary disease resistant to both diagnosis and treatment, and (3) a history of alcoholism.
A total of 59 cases, who visited the Dermatological Clinic of National Taiwan University Hospital in the past 27 years, was proved to be Sporotrichosis. The diagnostic criteria were the suggestive clinical pictures with any one of the following points: (1) positive fungal culture with characteristic colonies of Sporotrichum schenckii, (2) good therapeutic response to potassium iodide, (3) demonstration of fungal elements in the suggested pathological tissues or (4) demonstration of fungal elements in pus or tissue using direct immunofluorescence. All the informations concerning the clinical pictures and epidemiological points of view of these 59 patients were analysed. The chief cutaneous lesions were composed of nodules, ulcers or infiltrated plaques in linear arrangement on the exposed areas especially arms, legs or face. Thirty eight cases were male and 21 female. It affected peoples of the age between 4 to 70 years old, and their occupations were mainly outside workers such as agriculturist, worker, etc. Most of the affected people lived in the suburban areas of Taipei city such as Taoyuan and Taipei county. Serological tests such as precipitation, complement fixation and hemagglutination tests were performed in 12 cases, yet no reliable results were got.
A 63-year-old veterinarian acquired sporotrichosis presumably from handling an infected cat. Treatment was successfully completed with ketoconazole, 200 to 400 mg a day for eight weeks. No side effects were noted.
A case of sporotrichosis that is inscribed in the localizated cutaneous form of lower incidence in our country, is presented. We destacated its unusual localization and atypical aspect that planteated differential diagnosis of arduous elucidation.
A minor outbreak of culture-proved cutaneous sporotrichosis occurred in three employees of a commercial nursery in eastern Minnesota. All three had known exposure to sphagnum moss used for the packing of plant roots. Sporothrix schenkii was grown from a culture of sphagnum moss used at the nursery. The supplier of the moss is located in Wisconsin.
Mimicry by fungal infection of other chronic bone and joint diseases may easily result in a tardy diagnosis with subsequent needless surgery or permanent damage to the joint and its function. A case of sporotrichosis arthritis involving both wrists and knee joints is described. Diagnostic pitfalls and therapeutic dilemmas are outlined. The literature on this apparently 'rare' form of arthritis is reviewed.
We report a patient with systemic sporotrichosis and osteomyelitis without concomitant suppurative arthritis. To our knowledge this is the first such documented occurrence of hematogenous osteomyelitis in the systemic form of the disease. It was diagnosed by radionuclide bone scintigraphy and radiography and confirmed by biopsy.
The incidence of occupational mycoses and the main criteria to make a correct diagnosis are commented. The sources of infection of the superficial and deep professional mycotic infections are analysed. The occurrence of an epidemic outbreak of sporotrichosis in 13 members of one family is reported. The parents and 11 sibling were infected with the grass utilized for the filling of mattress, in a small domestic craftsmanship.
Pulmonary involvement during Sporotrichium schenkii infection can present as either primary pulmonary or systemic disease. The clinical and radiological features in the primary form closely resemble those of adult-type tuberculosis. On clinical, radiological and histopathological grounds pulmonary involvement during systemic spread can be difficult to distinguish from sarcoidosis. The diagnostic and therapeutic problems encountered in a woman with systemic sporotrichosis infection with pulmonary involvement are described.
A nursery worker contracted sporotrichosis of the abdomen after air-layering with sphagnum moss. The infection, resulting in a 4 by 6 cm ulcerated plaque, satellite lesion, and involvement of the epigastric lymphatics, resolved after two months of saturated potassium iodide therapy.
Sporotrichosis is the most common deep mycosis in many tropical regions. The etiologic agent, Sporotrichum schenckii, is easily cultivated but rarely seen in histologic sections.
Two patients with sporotrichosis, one of the cutaneous-lymphatic type, the other of the fixed cutaneous type, were treated with local heat therapy. The "pocket warmer" used for this purpose has the advantage of being able to maintain a constant temperature of 44 degrees-45 degrees C on the skin surface for several hours, while permitting unrestricted freedom of movement. There are no side effects. The duration of treatment depends on the type of lesion, location, depth, and size. Generally, local application for 1-2 h per day for 5-6 weeks seems to be sufficient.
About 1,100 cases of sporotrichosis were reported in Japan between 1955 and 1973. From February 1975, when our hospital opened, to November 1979, we encountered eight cases of this disease. The patients, two males and six females, were aged from 6 months to 90 years old. Among the clinical types, three cases were of the lymphangitic type and five cases were of the localized type. Seven cases treated with oral potassium iodine and one case treated with topical thermotherapy were cured or improved by such treatments. We report here these eight cases with a discussion on clinical manifestations in previous reports of cases in Japan.
Sporotrichosis is endemic in temperate and tropical regions of the world, including Australia. Although uncommon, it is frequently encountered in Northern Australia, especially in Queensland. All ages are affected, although most cases occur from occupational exposure to vegetation or soil. This article reviews the cause, diagnosis and treatment options of this fungal disease which affects the skin and is often misdiagnosed. It classically presents in gardeners, especially those handling roses.