Sporothrix schenckii

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Key Points

  • Sporothrix schenckii
    • Characteristics
      • Dimorphic fungus
        • Mold in nature
          • branching hyphae with “bouquet-like” rosettes of conidia
        • Yeast in human tissue
          • Cigar-shaped budding yeast
    • Transmission
      • Found in vegetation (“Rose-gardener’s disease”)
        • E.g. bark of trees, shrubs, garden plants
      • Acquired through break in skin (e.g. thorn prick)
        • Exposure is usually occupational (landscaper, rose-gardener, etc.)
    • Presentation: Sporotrichosis
      • Initial ulcerating nodule at site of puncture
        • Spreads along lymphatics, causing additional ulcers (ascending lymphangitis)
      • Disseminated disease possible in immunocompromised host
    • Diagnosis
      • Culture of fungus is gold standard
      • Biopsy of nodules reveal granulomas
    • Treatment
      • Itraconazole is first-line
        • Potassium iodide or terbinafine are second line
        • Amphotericin B is used for refractory disease