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Sporotrichosis

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Diagnosis and Treatment of Fungal Infections

Abstract

Sporotrichosis is a subacute to chronic fungal infection of skin and subcutaneous tissues. The causative agent, Sporothrix schenckii, is a dimorphic fungus that exists as a mold in the environment and as a yeast in tissues. S. schenckii is not a single species, but rather a complex of at least 6 phylogenetically different organisms. In the environment, S. schenckii is found in sphagnum moss, decaying wood, vegetation, hay, and soil. Infection occurs when a person is exposed to an environmental source, and the organism is inoculated through the skin. A large continuing outbreak in Rio de Janeiro is associated with zoonotic transmission from infected cats.

The most common manifestation of sporotrichosis is lymphocutaneous or localized cutaneous infection. Pulmonary sporotrichosis mimics reactivation tuberculosis and occurs most often in those who have chronic obstructive pulmonary disease. Osteoarticular sporotrichosis is uncommon and is found most often in middle-aged men. Disseminated and meningeal sporotrichosis are very uncommon; almost all patients have cellular immune deficiencies, and most cases are in persons with AIDS. Most patients who have sporotrichosis can be successfully treated with oral itraconazole although saturated solution of potassium iodide (SSKI) is still used in some countries. Those patients who have disseminated infection, meningitis, or severe pulmonary involvement should be treated initially with an intravenous amphotericin B formulation before transitioning to itraconazole.

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Authors and Affiliations

  1. Division of Infectious Diseases, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Health System, Ann Arbor, MI, USA

    Carol A. Kauffman

  2. Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI, USA

    Marisa H. Miceli

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Correspondence to Carol A. Kauffman .

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  1. Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Duane R. Hospenthal

  2. Departments of Pathology, Microbiology, and Clinical Laboratory Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Michael G. Rinaldi

  3. Departments of Medicine and Microbiology & Immunology, University of Maryland School of Medicine, Baltimore, MD, USA

    Thomas J. Walsh

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Kauffman, C.A., Miceli, M.H. (2023). Sporotrichosis. In: Hospenthal, D.R., Rinaldi, M.G., Walsh, T.J. (eds) Diagnosis and Treatment of Fungal Infections. Springer, Cham. https://doi.org/10.1007/978-3-031-35803-6_22

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