Sporotrichosis

What is sporotrichosis?

Sporotrichosis is a fungal infection caused by a fungus called Sporothrix schenckii. It usually infects the skin.

Who gets sporotrichosis?

Persons handling thorny plants, sphagnum moss, or baled hay are at increased risk of getting sporotrichosis. Outbreaks have occurred among nursery workers handling sphagnum moss, rose gardeners, children playing on baled hay, and greenhouse workers handling bayberry thorns contaminated by the fungus. A number of cases have recently occurred among nursery workers, especially workers handling sphagnum moss topiaries.

How is the fungus spread?

The fungus can be found in sphagnum moss, in hay, in other plant materials, and in the soil. It enters the skin through small cuts or punctures from thorns, barbs, pine needles, or wires. It is not spread from person to person.

What are the symptoms of sporotrichosis?

The first symptom is usually a small painless bump resembling an insect bite. It can be red, pink, or purple in colour. The bump (nodule) usually appears on the finger, hand, or arm where the fungus first enters through a break on the skin. This is followed by one or more additional bumps or nodules which open and may resemble boils. Eventually lesions look like open sores (ulcerations) and are very slow to heal. The infection can spread to other areas of
the body.

Does sporotrichosis involve any other organs besides the skin?

The majority of infections are limited to the skin. Cases of joint, lung, and central nervous system infection have occurred but are very rare. Usually they occur only in persons with previous disorders of the immune system.

How soon do symptoms appear?

The first nodule may appear any time from 1 to 12 weeks after exposure to the fungus. Usually the nodules are visible within 3 weeks after the fungus enters the skin.

How is sporotrichosis diagnosed?

Sporotrichosis can be confirmed when a doctor obtains a swab or a biopsy of a freshly opened skin nodule and submits it to a laboratory for fungal culture.

If I have symptoms should I see my doctor?

Yes. It is important for the diagnosis to be confirmed by a doctor so that proper treatment can be provided.

How is sporotrichosis treated?

Sporotrichosis is generally treated with potassium iodide, taken by mouth in droplet form. A new drug, called itraconazole (Sporanox), is available for treatment, but experience with this drug is still limited. Treatment is often extended over a number of weeks, until the skin lesions are completely healed.

How can sporotrichosis be prevented?

Control measures include wearing gloves and long sleeves when handling wires, rose bushes, hay bales, conifer (pine) seedlings, or other materials that may cause minor skin breaks. It is also advisable to avoid skin contact with sphagnum moss. Moss has been implicated as a source of the fungus in a number of outbreaks.