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PubMed1986

Sporotrichosis in India: first authentic case report from the north-western region and a critical literature review.

The first case of sporotrichosis from north-western region is reported along with a critical review of the work done on this disease in India. The patient, a 55-year-old housewife with multiple lymphocutaneous lesions on her left arm, had never travelled to north-eastern India where sporotrichosis occurs endemically. She was a resident of Ranikhet, District Nainital, Uttar Pradesh (U.P.), situated about 235 km north-east of Delhi. The diagnosis was established by demonstration of Sporothrix schenckii through direct microscopy and culture of pus collected from multiple suppurative lesions, verification of the dimorphic character of the fungus in vitro and its pathogenicity to white mice. She was treated successfully with oral administration of potassium iodide for 6 weeks.

Animals↗

PubMed1992

Laboratory-acquired sporotrichosis.

A case of laboratory-acquired sporotrichosis is described that was associated with research activities involving isolates of Sporothrix schenckii from the 1988 sporotrichosis epidemic in the USA. Infection occurred in the absence of apparent trauma or other predisposing factors. The possibility that S. schenckii can invade healthy and intact skin is suggested.

Administration, Oral↗

PubMed2003

Potassium iodide remains the most effective therapy for cutaneous sporotrichosis.

Sporotrichosis is a subcutaneous fungal infection caused by the dimorphic fungus Sporothrix schenckii. Itraconazole has largely replaced older therapies, but we present a case of lymphocutaneous sporotrichosis that failed to respond to an adequate course of itraconazole yet responded dramatically to treatment with saturated solution of potassium iodide (SSKI).

Administration, Topical↗

PubMed2003

A case of sporotrichosis treated with itraconazole.

Lymphocutaneous sporotrichosis is caused by Sporothrix schenckii, a dimorphic fungus commonly existing on decaying plants and in the soil. The fungus has a worldwide distribution but is more prevalent in temperate and tropical climates. Infection may result from traumatic inoculation of contaminated material such as soil, hay, moss, plant debris, splinters, thorns and barbs. Inoculation is also possible through some animal scratches and bites. We describe a typical case of lymphocutaneous sporotrichosis, which was confirmed by clinical, histological and microbiological features. The patient was successfully treated with 400 mg daily systemic itraconazole for 4 months.

Adult↗

PubMed2005

Multifocal sporotrichosis with meningeal involvement in a patient with AIDS.

This report describes a 29-year-old man with AIDS and disseminated lymphocutaneous sporotrichosis diagnosis presenting a poor therapeutic adhesion to itraconazole therapy that later evolved to neurological impairment and death. Necropsy showed granulomatous reaction and yeast-like forms similar to Sporothrix schenckii in meninges, lymph nodes, marrow bone, skin, testicles, epididymides and pancreas. Meningeal sporotrichosis cases associated to AIDS are reviewed in brief.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Disseminated sporotrichosis and Sporothrix schenckii fungemia as the initial presentation of human immunodeficiency virus infection.

Infection with Sporothrix schenckii causes a localized lymphocutaneous disease in the immunocompetent host, while it frequently results in disseminated disease in the immunocompromised patient. There are a growing number of reports of S. schenckii infection in the human immunodeficiency virus (HIV)-infected population, where the disease usually starts as a localized cutaneous lesion and subsequently disseminates. The optimal treatment of systemic sporotrichosis in HIV-positive patients is as yet unknown. This article presents a case report of disseminated sporotrichosis in an HIV-infected patient, a review of the literature, and discussion of treatment options for HIV-infected patients.

AIDS-Related Opportunistic Infections↗

PubMed2001

Successful treatment of AIDS-related disseminated cutaneous sporotrichosis with itraconazole.

Sporotrichosis is a chronic granulomatous mycosis caused by a dimorphic fungus, Sporothrix schenckii. The most common manifestations of infection are lymphocutaneous and fixed-cutaneous types. In the case of immunosuppressed patients, and particularly in patients with acquired immune deficiency syndrome (AIDS), it occurs as disseminated cutaneous disease. This is a report of a 28-year-old male patient who presented with disseminated cutaneous and hematogenous sporotrichosis involving multiple ulcerative, nodular lesions in various body areas. Treatment consisted of 300 mg/d of itraconazole, which resulted in clinical and mycological cure.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Treatment of systemic sporotrichosis with ketoconazole.

Infections of deep soft tissues with the dimorphic fungus Sporothrix schenckii are uncommon in humans, and therapy has often required toxic drugs. We report our experience in treating 11 patients who had deep-seated sporotrichosis with ketoconazole, a well-tolerated, orally absorbed antifungal agent. Eight infections involved one or more joints, and three involved thoracic, cervical, and widespread cutaneous sites, respectively. For eight patients all evidence of infection resolved during therapy. Sustained remissions (6 months to 5 years) were noted for six patients after the discontinuation of all therapy and for an additional patient 4 years after the initiation of ketoconazole treatment. Durable responses were associated with prolonged treatment with 400-800 mg of ketoconazole daily. Our favorable experience suggests that oral therapy with ketoconazole may benefit other patients with systemic sporotrichosis.

Adult↗

PubMedDate not supplied

Treatment of pulmonary sporotrichosis with ketoconazole.

Antifungal therapy that included ketoconazole failed in a 44-year-old woman with pulmonary sporotrichosis progressing slowly over a seven-year period. On the basis of this case and the modest amount of experience reported in the literature, ketoconazole does not appear to be effective in the treatment of pulmonary sporotrichosis.

Adult↗

PubMed1979

Cell-mediated immune responses in sporotrichosis.

Cell-mediated immunity (CMI) was evaluated in five patients with cutaneous sporotrichosis and six patients with systemic sporotrichosis. Whereas patients with cutaneous disease showed normal CMI, the patients with systemic disease had significant abnormalities in CMI. Most patients exhibited responses to a sporothrix antigen, measured either in conventional assays of lymphocyte transformation or in preincubation assays. Two patients with protracted illnesses and continued abnormalities in CMI were treated with transfer factor and showed improvement in parameters of CMI and control of their disease.

Adolescent↗

PubMed1992

A multistate outbreak of sporotrichosis associated with sphagnum moss.

In the spring of 1988, the largest documented US outbreak of cutaneous sporotrichosis to date occurred, with 84 cases among persons from 15 states who were exposed to Wisconsin-grown sphagnum moss used in packing evergreen tree seedlings. In New York State, 13 cases occurred among 109 forestry workers. All 13 cases occurred among 76 workers who had handled evergreen seedlings and moss (attack rate = 17%). For those exposed to evergreens and moss, the risk of infection increased as worktime exposure to moss increased (attack rates: less than 10 hours, 8%; 10-19 hours, 12%; greater than 19 hours, 33%). While environmental samples of moss from the Wisconsin supplier were negative, Sporothrix schenckii was cultured from multiple samples of the sphagnum moss obtained from one of six Pennsylvania tree nurseries, representing the nursery that was identified as the source for 79 (94%) of the moss-associated cases. Differences in tree-handling procedures at this nursery--including the use of 1- to 3-year-old moss to pack seedlings, use of a pond water source to wet the moss, use of an organic polymer gel on the seedling root system, and underground storage and longer storage of moss-packed seedlings before shipping--suggested possible explanations for the association. Efforts to prevent sporotrichosis among persons handling evergreen seedlings should include the use of alternate types of packing material (e.g., cedar wood chips or shredded paper) and protective clothing such as gloves and long-sleeved shirts.

Adolescent↗

PubMed1989

Pulmonary sporotrichosis with massive hemoptysis.

Pulmonary sporotrichosis is an uncommon condition that may mimic tuberculosis. We present a patient who, years after antifungal therapy, presented with massive pulmonary hemorrhage. Although such life-threatening hemoptysis caused by sporotrichosis is rare, the possibility of this complication of progressive disease should influence decisions regarding medical and surgical treatment of patients with extensive cavitary involvement.

Hemoptysis↗

PubMed2001

Endemic sporotrichosis.

Although first reported more than a century ago, sporotrichosis, caused by Sporothrix schenckii, still remains a poorly studied disease. Results from recently published studies on sporotrichosis in endemic areas are summarised and assembled with previous findings, providing a comprehensive review that highlights the needs for further research.

Adolescent↗

PubMed2001

Unsuspected sporotrichosis in childhood.

We report 10 prepubertal girls with sporotrichosis who were misdiagnosed because they had solitary ulcerative skin nodules, rather than a "sporotrichoid" pattern of multiple linear nodules. All had positive cultures for Sporothrix schenckii. We urge clinicians to consider sporotrichosis in the differential diagnosis of a solitary skin nodule.

Child↗

PubMed1992

Treatment of cutaneous sporotrichosis with terbinafine.

Terbinafine, an allylamine antifungal agent, has been shown to have excellent in-vitro activity against dermatophytes. Several other fungi of importance also show in-vitro sensitivity. Because terbinafine is fungicidal rather than fungistatic in action, its efficacy in treating such fungal infections requires evaluation. Five patients with cutaneous sporotrichosis were treated with 250 mg of terbinafine twice daily. All of the patients were cured. Overall, the clinical response was rapid. In three patients, negative culture was achieved within 8 weeks; in the other two, negative culture was obtained at 12 and 32 weeks, respectively. Terbinafine was well tolerated, although one patient developed erectile dysfunction while receiving treatment. This was completely resolved on stopping the treatment. The treatment of sporotrichosis is also reviewed in this article.

Adult↗

PubMed1979

Sporotrichosis.

Five cases of cutaneous sporotrichosis were seen at the Stanford University Department of Dermatology from 1966 to 1977, where the disease was previously unreported. The possibility of sporotrichosis should be considered when suppurative cutaneous lesions do not respond to antibacterial agents. Skin biopsy of sporotrichotic lesion is often nonspecific, while culture is the best method of diagnosis.

Adult↗

PubMed1983

Extracutaneous sporotrichosis.

The typical infection with Sporothrix schenckii is characterized by superficial cutaneous nodules occurring along the lines of lymphatic drainage of the limbs. Review of the medical records at the Mayo Clinic from 1937 to the present disclosed 58 patients with sporotrichosis. Eleven patients had evidence of extracutaneous infection. Eight of the patients were men whose ages ranged from 25 to 71 years; the ages of the three women were 54, 64, and 67. Seven patients had predominantly joint involvement, with the knee and wrist joints being most often infected. Other sites of infection included the mandible and ethmoid sinuses. Three patients had disseminated systemic infection, and one patient died within a year of the initial diagnosis. Nine patients had been in good health before the infection, although five patients were taking systemic corticosteroids before their infection was diagnosed. Therapies included supersaturated potassium iodide, amphotericin B, and 2-hydroxystilbamidine isethionate. Although most commonly seen as a cutaneous disease, sporotrichosis is a potentially disseminated infection with life-threatening consequences.

Adult↗

PubMed2004

Importance of the direct fresh examination in the diagnosis of cutaneous sporotrichosis.

BACKGROUND: To date the direct fresh examination has not been considered, except by a few authors, as a valid laboratory procedure for the diagnosis of cutaneous sporotrichosis. METHODS: Forty-two patients with cutaneous sporotrichosis (36 lymphangitic and six fixed) were studied. Pus was obtained through digital compression of opened lesions followed by collection with a spatula and examination of the material between the slide and the coverslip. Cultures on Sabouraud's glucose agar slants with cloramphenicol and cicloheximide were made in all cases. RESULTS: Direct, fresh examination asteroid bodies of Sporothrix schenckii were found in 85.7% of the cases, which allowed the authors to immediately diagnose the disease. Cultures confirmed the diagnosis in 95.2% of the patients. CONCLUSIONS: Fastness, simplicity and low cost of the fresh examination lead us to recommend systematic use of the method for primary diagnosis of the disease, mainly at first level public health laboratories.

Adolescent↗