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Sporotrichosis

  • Carol A. KauffmanEmail author
Chapter
Part of the Infectious Disease book series (ID)

Abstract

Sporotrichosis is a subacute to chronic mycotic 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 the tissues. S. schenckii is not a single species, but rather a complex of at least six 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. Outbreaks of sporotrichosis have been traced back to contaminated wood, sphagnum moss, and hay. 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 who are alcoholics. 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 developing 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.

Keywords

Sporotrichosis Sporothrix schenckii Cat-associated sporotrichosis Lymphocutaneous infection Itraconazole SSKI Amphotericin B 

References

  1. 1.
    Kwon-Chung KJ. Comparison of isolates of Sporothrix schenckii obtained from fixed cutaneous lesions with isolates from other types of lesions. J Infect Dis. 1979;139:424–31.CrossRefPubMedGoogle Scholar
  2. 2.
    Marimon R, Gene J, Cano J, et al. Molecular phylogeny of Sporothrix schenckii. J Clin Microbiol. 2006;44:3251–6.CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Marimon R, Cano J, Gene J, et al. Sporothrix brasiliensis, S. globosa, and S. mexicana, three new Sporothrix species of clinical interest. J Clin Microbiol. 2007;45:3198–206.CrossRefPubMedCentralPubMedGoogle Scholar
  4. 4.
    Rodrigues AM, deHoog S, Camargo ZP. Emergence of pathogenicity in the Sporothrix schenckii complex. Med Mycol. 2013;51:405–12.CrossRefPubMedGoogle Scholar
  5. 5.
    Lopez-Romero E, Reyes-Montes MR, Perez-Torres A, et al. Sporothrix schenckii complex and sporotrichosis, an emerging health problem. Future Microbiol. 2011;6:85–102.CrossRefPubMedGoogle Scholar
  6. 6.
    Dixon DM, Salkin IF, Duncan RA, et al. Isolation and characterization of Sporothrix schenckii from clinical and environmental sources associated with the largest U.S. epidemic of sporotrichosis. J Clin Microbiol. 1991;29:1106–13.PubMedCentralPubMedGoogle Scholar
  7. 7.
    Zhang X, Andrews JH. Evidence for growth of Sporothrix schenckii on dead but not on living sphagnum moss. Mycopathologia. 1993;123:87–94.CrossRefPubMedGoogle Scholar
  8. 8.
    Pappas PG, Tellez I, Deep AE, et al. Sporotrichosis in Peru: description of an area of hyperendemicity. Clin Infect Dis. 2000;30:65–70.CrossRefPubMedGoogle Scholar
  9. 9.
    Lyon GM, Zurita S, Casquero J, et al. Population-based surveillance and a case-control study of risk factors for endemic lymphocutaneous sporotrichosis in Peru. Clin Infect Dis. 2003;36:34–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Conti Diaz IA. Epidemiology of sporotrichosis in Latin America. Mycopathologia. 1989;108:113–6.PubMedGoogle Scholar
  11. 11.
    Reed KD, Moore FM, Geiger GE, Stemper ME. Zoonotic transmission of sporotrichosis: case report and review. Clin Infect Dis. 1993;16:384–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Cooper CR, Dixon DM, Salkin IF. Laboratory-acquired sporotrichosis. J Med Vet Mycol. 1992;30:169–71.CrossRefPubMedGoogle Scholar
  13. 13.
    Powell KE, Taylor A, Phillips BJ, et al. Cutaneous sporotrichosis in forestry workers. Epidemic due to contaminated sphagnum moss. JAMA. 1978;240:232–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Hajjeh R, McDonnell S, Reef S, et al. Outbreak of sporotrichosis among tree nursery workers. J Infect Dis. 1997;76:499–504.CrossRefGoogle Scholar
  15. 15.
    Dooley DP, Bostic PS, Beckius ML. Spook house sporotrichosis. A point-source outbreak of cutaneous sporotrichosis from hay bale props in a Halloween haunted-house. Arch Intern Med. 1997;157:1885–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Barros MBL, Schubach AO, do Valle ACF, et al. Cat-transmitted sporotrichosis epidemic in Rio de Janeiro, Brazil: description of a series of cases. Clin Infect Dis. 2004;38:529–35.CrossRefPubMedGoogle Scholar
  17. 17.
    Galhardo MCG, Oliveira RMZ, do Valle ACF, et al. Molecular epidemiology and antifungal susceptibility patterns of Sporothrix schenckii isolates from a cat-transmitted epidemic of sporotrichosis in Rio de Janeiro, Brazil. Med Mycol. 2008;46:141–51.CrossRefPubMedGoogle Scholar
  18. 18.
    Kovarik CL, Neyra E, Bustamante B. Evaluation of cats as the source of endemic sporotrichosis in Peru. Med Mycol. 2008;46:53–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Leme LRP, Schubach TMP, Santos IB, et al. Mycological evaluation of bronchoalveolar lavage in cats with respiratory signs from Rio de Janeiro, Brazil. Mycoses. 2007;50:210–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Tsuboi R, Sanada T, Takamori K, Ogawa H. Isolation and properties of extracellular proteinases from Sporothrix schenckii. J Bacteriol. 1987;169:4104–9.PubMedCentralPubMedGoogle Scholar
  21. 21.
    Cunningham KM, Bulmer GS, Rhoades ER. Phagocytosis and intracellular fate of Sporothrix schenckii. J Infect Dis. 1979;140:815–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Shiraishi A, Nakagaki K, Arai T. Role of cell-mediated immunity in the resistance to experimental sporotrichosis in mice. Mycopathologia. 1992;120:15–21.CrossRefPubMedGoogle Scholar
  23. 23.
    Tachibana T, Matsuyama T, Mitsuyama M. Involvement of CD4 + T cells and macrophages in acquired protection against infection with Sporothrix schenckii in mice. Med Mycol. 1999;37:397–404.CrossRefPubMedGoogle Scholar
  24. 24.
    Freitas DFS, Hoagland BS, do Valle ACF, et al. Sporotrichosis in HIV-infected patients: report of 21 cases of endemic sporotrichosis in Rio de Janeiro, Brazil. Med Mycol. 2012;50:170–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Bustamante B, Lama JR, Mosquera C, Soto L. Sporotrichosis in human immunodeficiency virus infected Peruvian patients. Infect Dis Clin Pract. 2009;17:78–83.CrossRefGoogle Scholar
  26. 26.
    Bunce PE, Yang L, Chun S, et al. Disseminated sporotrichosis in a patient with hairy cell leukemia treated with amphotericin B and posaconazole. Med Mycol. 2012;50:197–201.CrossRefPubMedGoogle Scholar
  27. 27.
    Gottlieb GS, Lesser CF, Holmes KK, Wald A. Disseminated sporotrichosis associated with treatment with immunosuppressants and tumor necrosis factor–alpha antagonists. Clin Infect Dis. 2003;37:638–40.Google Scholar
  28. 28.
    Wong S-M, Tang JJ. Disseminated sporotrichosis in a patient with a past history of lepromatous leprosy: a case report. Med Mycol. 2012;50:404–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Kauffman CA. Sporotrichosis. Clin Infect Dis. 1999;29:231–7.CrossRefPubMedGoogle Scholar
  30. 30.
    Smego RA, Castiglia M, Asperilla MO. Lymphocutaneous syndrome. A review of non-Sporothrix causes. Medicine (Baltimore). 1999;78:38–63.CrossRefGoogle Scholar
  31. 31.
    Pluss JL, Opal SM. Pulmonary sporotrichosis: review of treatment and outcome. Medicine (Baltimore). 1986;65:143–53.CrossRefGoogle Scholar
  32. 32.
    Aung AK, Teh MB, McGrath C, Thompson PJ. Pulmonary sporotrichosis: case series and systematic analysis of literature on clinic-radiological patterns and management outcomes. Med Mycol. 2013;51:534–44.CrossRefPubMedGoogle Scholar
  33. 33.
    TiwariA MAN. Primary pulmonary sporotrichosis. case report and review of the literature. Infect Dis Clin Pract. 2012;20:25–7.CrossRefGoogle Scholar
  34. 34.
    Winn RE, Anderson J, Piper J, Aronson NE, Pluss J. Systemic sporotrichosis treated with itraconazole. Clin Infect Dis. 1993;17:210–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Atdjian M, Granda JL, Ingberg HO, Kaplan BL. Systemic sporotrichosis polytenosynovitis with median and ulnar nerve entrapment. JAMA. 1980;243:1841–2.CrossRefPubMedGoogle Scholar
  36. 36.
    Al-Tawfiq JA, Wools KK. Disseminated sporotrichosis and Sporothrix schenckii fungemia as the initial presentation of human immunodeficiency virus infection. Clin Infect Dis. 1998;26:1403–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Quintella LP, Passos SRL, do Valle ACF, et al. Histopathology of cutaneous sporotrichosis in Rio de Janeiro: a series of 119 consecutive cases. J Cutan Pathol. 2011;38:25–32.CrossRefPubMedGoogle Scholar
  38. 38.
    Hussein MR. Mucocutaneous Splendore-Hoeppli phenomenon. J Cutan Pathol. 2008;35:979–88.CrossRefPubMedGoogle Scholar
  39. 39.
    Hu S, Chung W-H, Hung S-I, et al. Detection of Sporothrix schenckii in clinical samples by a nested PCR assay. J Clin Microbiol. 2003;41:1414–8.CrossRefPubMedCentralPubMedGoogle Scholar
  40. 40.
    Liu X, Zhang Z, Hou B, et al. Rapid identification of Sporothrix schenckii in biopsy tissue by PCR. J Eur Acad Dermatol Venereol. 2013;27:1491–7.CrossRefPubMedGoogle Scholar
  41. 41.
    Kauffman CA, Bustamante B, Chapman SW, Pappas PG. Clinical practice guidelines for the management of patients with sporotrichosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007;45:1255–65.CrossRefPubMedGoogle Scholar
  42. 42.
    Oliveira DC, Lopes PGM, Spader TB, et al. Antifungal susceptibilities of Sporothrix albicans, S. brasiliensis, and S. luriei of the S. schenckii complex identified in Brazil. J Clin Microbiol. 2011;49:3047–9.CrossRefPubMedCentralPubMedGoogle Scholar
  43. 43.
    Marimon R, Serena C, Gene J, Cano J, Guarro J. In vitro susceptibilities of five species of Sporothrix. Antimicrob Agents Chemother. 2008;52:732–4.CrossRefPubMedCentralPubMedGoogle Scholar
  44. 44.
    Barros MBL, Schubach AO, Oliveira RVC, et al. Treatment of cutaneous sporotrichosis with itraconazole—study of 645 patients. Clin Infect Dis. 2011;52:e200–e6.CrossRefGoogle Scholar
  45. 45.
    Sharkey-Mathis PK, Kauffman CA, Graybill JR, et al. Treatment of sporotrichosis with itraconazole. Am J Med. 1993;95:279–85.CrossRefPubMedGoogle Scholar
  46. 46.
    Restrepo A, Robledo J, Gomez I, Tabares AM, Gutierrez R. Itraconazole therapy in lymphangitic and cutaneous sporotrichosis. Arch Dermatol. 1986;122:413–7.CrossRefPubMedGoogle Scholar
  47. 47.
    Rex JH, Bennett JE. Administration of potassium iodide to normal volunteers does not increase killing of Sporothrix schenckii by their neutrophils and monocytes. J Med Vet Mycol. 1990;28:185–9.CrossRefPubMedGoogle Scholar
  48. 48.
    Sterling JB, Heymann WR. Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol. 2000;43:691–7.CrossRefPubMedGoogle Scholar
  49. 49.
    Chapman SW, Pappas P, Kauffman C, et al. Comparative evaluation of the efficacy and safety of two doses of terbinafine (500 and 1000 mg day−1) in the treatment of cutaneous or lymphocutaneous sporotrichosis. Mycoses. 2003;47:62–8.CrossRefGoogle Scholar
  50. 50.
    Kauffman CA, Pappas PG, McKinsey DS, et al. Treatment of lymphocutaneous and visceral sporotrichosis with fluconazole. Clin Infect Dis. 1996;22:46–50.CrossRefPubMedGoogle Scholar
  51. 51.
    Fernandez-Silva F, Capilla J, Mayayo E, Guarro J. Efficacy of posaconazole in murine experimental sporotrichosis. Antimicrob Agents Chemother. 2012;56:2273–7.CrossRefPubMedCentralPubMedGoogle Scholar
  52. 52.
    Hiruma M, Kagawa S. The effects of heat on Sporothrix schenckii in vitro and in vivo. Mycopathologia. 1998;84:21–30.CrossRefGoogle Scholar
  53. 53.
    Hiruma M, Kawada A, Noguchi H, Ishibashi A, Conti Diaz IA. Hyperthermic treatment of sporotrichosis: experimental use of infrared and far infrared rays. Mycoses. 1992;35:293–9.CrossRefPubMedGoogle Scholar
  54. 54.
    Downs NJ, Hinthorn DR, Mhatre VR, Liu C. Intra-articular amphotericin B treatment of Sporothrix schenckii arthritis. Arch Intern Med. 1989;149:954–5.CrossRefPubMedGoogle Scholar

Suggested Reading

  1. de Lima Barros M, Paes RA, Schubach AO. Sporothrix schenckii and sporotrichosis. 2011;24:633–54.Google Scholar
  2. Kauffman CA. Old and new therapies for sporotrichosis. Clin Infect Dis 1995;21:981–5.CrossRefPubMedGoogle Scholar
  3. Pappas PG. Sporotrichosis. In: Kauffman CA, Pappas PG, Sobel JD, Dismukes WE, editors. Essentials of medical mycology. 2nd ed.New York: Springer. 2011. pp 387–98.CrossRefGoogle Scholar
  4. Rodrigues AM, de Hoog GS, de Casa Pires D, et al. Genetic diversity and antifungal susceptibility profiles in causative agents of sporotrichosis. BMC Infect Dis 2014;14:219–27.CrossRefPubMedCentralPubMedGoogle Scholar
  5. Wilson DE, Mann JJ, Bennett JE, Utz JP. Clinical features of extracutaneous sporotrichosis. Medicine (Baltimore) 1967;46:265–79.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Infectious Diseases Section, Veterans Affairs Ann Arbor Healthcare System, Internal MedicineUniversity of Michigan Medical SchoolAnn ArborUSA

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