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At least 19 recordsLinked to original sources
PubMed1997

Spook house sporotrichosis. A point-source outbreak of sporotrichosis associated with hay bale props in a Halloween haunted-house.

While isolated cases of sporotrichosis typically occur following contact with contaminated plant materials, outbreaks are distinctly unusual. A temporal increase in the incidence of sporotrichosis in a dermatology practice at a military installation in southwestern Oklahoma prompted an investigation. Patients with sporotrichosis presenting to a single dermatologist in the winter of 1992-1993 were interviewed, epidemiological data were collected, and fungal cultures were obtained from incriminated hay fields. Five patients presented with cutaneous sporotrichosis during a 5-week period beginning in December 1992. Four patients had maintained hay bales in a Halloween haunted house and the fifth patient had visited the house once. As in 3 previous reports, this outbreak was associated with stored hay or hay bales harvested in the US plains states. Contact with hay should be recognized as a risk factor for infection with Sporothrix schenckii. Outbreaks are possible given adequate intensity of exposure and may be difficult to recognize because of the delayed presentation of clinical illness.

Adult↗
PubMed2001

Sporotrichosis masquerading as pyoderma gangrenosum: case report and review of 19 cases of sporotrichosis.

We present the case of a 59-year-old woman who had large ulcerations on her right leg that were diagnosed initially as pyoderma gangrenosum and treated with three immunosuppressive agents (cyclosporin, prednisone and azathioprine) for 6 months. Results of a biopsy at 6 months showed numerous cigar-shaped bodies consistent with Sporothrix schenckii; identification was confirmed by tissue culture. A retrospective review was performed for all cases diagnosed as sporotrichosis from tissue culture or biopsy specimens at the Mayo Clinic. Nineteen cases were identified. The present case was the only one in which fungal organisms were visible on histological examination. The present case emphasizes the importance of making a definitive histological diagnosis in unusual ulcer cases or in suspected cases of pyoderma gangrenosum before the initiation of immunosuppressive therapy. The large number of cigar-shaped bodies in the tissue is a rare finding in sporothrix infection and has been reported in only two cases previously.

Biopsy, Needle↗
PubMed2000

Practice guidelines for the management of patients with sporotrichosis. For the Mycoses Study Group. Infectious Diseases Society of America.

UNLABELLED: The recommendations for the treatment of sporotrichosis were derived primarily from multicenter, nonrandomized treatment trials, small retrospective series, and case reports; no randomized, comparative treatment trials have been reported. Most cases of sporotrichosis are non life-threatening localized infections of the skin and subcutaneous tissues that can be treated with oral antifungal agents. The treatment of choice for fixed cutaneous or lymphocutaneous sporotrichosis is itraconazole for 36 months. The preferred treatment for osteoarticular sporotrichosis also is itraconazole, but therapy must be continued for at least 12 months. Pulmonary sporotrichosis responds poorly to treatment. Severe infection requires treatment with amphotericin B; mild to moderate infection can be treated with itraconazole. Meningeal and disseminated forms of sporotrichosis are rare and usually require treatment with amphotericin B. AIDS patients most often have disseminated infection and require life-long suppressive therapy with itraconazole after initial use of amphotericin B. OVERVIEW: Sporotrichosis is caused by the dimorphic fungus Sporothrix schenckii, which is found throughout the world in decaying vegetation, sphagnum moss, and soil. The usual mode of infection is by cutaneous inoculation of the organism. Pulmonary and disseminated forms of infection, although uncommon, can occur when S. schenckii conidia are inhaled. Infections are most often sporadic and usually associated with trauma during the course of outdoor work. Infection can also be related to zoonotic spread from infected cats or scratches from digging animals, such as armadillos. Outbreaks have been well-described and often are traced back to activities that involved contaminated sphagnum moss, hay, or wood. Most cases of sporotrichosis are localized to the skin and subcutaneous tissues. Dissemination to osteoarticular structures and viscera is uncommon and appears to occur more often in patients who have a history of alcohol abuse or immunosuppression, especially AIDS. Spontaneous resolution of sporotrichosis is rare, and treatment is required for most patients. Although sporotrichosis localized to skin and subcutaneous tissues is readily treated, management of osteoarticular, other localized visceral, and disseminated forms of sporotrichosis is difficult. OBJECTIVE: The objective of these guidelines is to provide recommendations for the treatment of various forms of sporotrichosis. OUTCOMES: The desired outcomes of treatment include eradication of S. schenckii from tissues, resolution of symptoms and signs of active infection, and return of function of involved organs. In persons with AIDS, eradication of the organism may not be possible, but clinical resolution should be attained and subsequently maintained with suppressive antifungal therapy. EVIDENCE: The English-language literature on the treatment of sporotrichosis was reviewed. Although randomized, blinded, controlled treatment trials were sought, none were found to have been performed for the treatment of sporotrichosis. Therefore, most weight was placed on those reports that were derived from multicenter trials of specific treatment modalities for sporotrichosis. Small series from a single institution and individual case reports were accorded less importance. VALUES: The highest value was placed on clinical efficacy and the ability of the antifungal regimen to eradicate the organism, but safety, tolerability, and cost of therapy were also valued. BENEFITS AND COSTS: The benefits of successfully treating sporotrichosis accrue primarily for the patient. Because this infection is not spread from person-to-person, public health aspects of treatment are of minor importance. Most forms of sporotrichosis are not life-threatening; thus, therapy is aimed at decreasing morbidity, improving quality of life, and allowing the patient to return to occupational and familial pursuits. (ABSTRACT TRUNCATED)

AIDS-Related Opportunistic Infections↗
PubMed1989

Sporotrichosis.

Sporotrichosis is a chronic fungal infection that most commonly involves the skin and lymphatics. It is classified into five forms: classic lymphocutaneous, fixed cutaneous, disseminated cutaneous, primary pulmonary, and systemic sporotrichosis. Its diagnosis is established by fungal culture or by direct immunofluorescence. Safe effective therapy for cutaneous sporotrichosis exists in the form of oral potassium iodide and local heat therapy. However, itraconazole, one of the newer triazole antimycotic agents, appears quite effective against Sporothrix schenckii and may provide a means of reducing both the length of therapy and the relapse rate. Systemic sporotrichosis, although still rare, is becoming more common, especially in immunosuppressed patients. Because of multisystem involvement, both diagnosis and management of patients with systemic sporotrichosis are difficult. Serologic antibody tests such as the slide latex agglutination test are useful to confirm the diagnosis and to determine the effectiveness of antifungal therapy. Intravenous amphotericin B is still considered the drug of choice for systemic sporotrichosis, but the search for a less toxic agent continues. Also, combination drug therapy and surgical intervention are necessary for some patients with extracutaneous sporotrichosis.

Administration, Oral↗
PubMedDate not supplied

Sporotrichosis in Himachal Pradesh (north India).

Sporotrichosis is being increasingly reported from a particular area of Himachal Pradesh, a state in north-west India. A skin-test survey was conducted using sporotrichin and peptido-rhamnomannan antigen among the population in the villages where 2 or more cases of sporotrichosis had been reported and results were compared with those for villages of the same where no case of sporotrichosis had been reported. The study was helped by local doctors, leaders and patients who were cured of sporotrichosis. The delayed-hypersensitivity positivity rates were significantly higher in case villages (range 22.9-40.0%) compared to control area (range 6.5-7.6%). Analysis by age showed that positivity rate increased with increase in age for both sexes. Analysis by occupation showed higher skin-test positivity in populations engaged in horticulture, nursery work, gardening, woodwork (43.2%) and farming (33.9%). The case villages have lower temperature and higher rainfall than the control villages. During the 1-year study period (1996-97), 25 cases of sporotrichosis were diagnosed: 16 cases were referred by doctors from the local area and 9 were from cases suspected during the skin-test survey. This study identifies Kangra district and adjoining areas in Himachal Pradesh as an endemic region for sporotrichosis and highlights the need for evaluation of geo-climatically similar areas.

Adult↗
PubMed1995

Old and new therapies for sporotrichosis.

The old therapies for sporotrichosis--saturated solution of potassium iodide (SSKI) and amphotericin B--have largely been supplanted by itraconazole treatment. Although SSKI is effective for the treatment of lymphocutaneous sporotrichosis, it is difficult to administer and is frequently associated with side effects; response rates of >90% are associated with itraconazole therapy for lymphocutaneous sporotrichosis. Patients with osteoarticular sporotrichosis rarely have systemic symptoms and can be effectively treated with a prolonged course of itraconazole, thus obviating the need for intravenous amphotericin B therapy with its associated toxic effects. Pulmonary sporotrichosis in patients infected with human immunodeficiency virus continue to be difficult therapeutic problems, but itraconazole appears to be at least as effective as amphotericin B as treatment for these forms of sporotrichosis.

Amphotericin B↗
PubMed1980

Pulmonary sporotrichosis.

Sporotrichosis is frequently primary in the lungs, caused by inhalation or aspiration of spores of Sporothrix schenckii. The clinical features and roentgenographic changes are nonspecific and usually indistinguishable from reactivated pulmonary tuberculosis. Therefore, pulmonary sporotrichosis should be considered when the tuberculin test and sputum cultures for Mycobacterium tuberculosis are persistently negative. Direct fluorescent antibody is a reliable, rapid, and specific method of identifying organisms in specimens and tissue biopsies. While the agglutination test is very sensitive in detecting sporotrichosis, it does not differentiate active disease from inactive disease. The complement fixation test, when positive, may suggest the presence of systemic sporotrichosis. Potassium iodide may be used initially in the nonimmunocompromised host with limited, noncavitary pulmonary disease. Amphotericin B should be given to patients who fail to respond to potassium iodide. Initial amphotericin B therapy is indicated in immunocompromised patients, in patients with multifocal systemic sporotrichosis. and in those with cavitary pulmonary sporotrichosis. Resectional surgery with perioperative medical therapy is indicated in patients with persistent cavitary disease unresponsive to amphotericin B, or when cavitary disease is associated with bleeding.

Adult↗
PubMed1994

Epidemic cutaneous sporotrichosis.

BACKGROUND: Sporotrichosis is a subcutaneous fungal infection. Lymphocutaneous and fixed sporotrichosis are the most common forms; cases of disseminated sporotrichosis are rare. There have been isolated reports and some epidemic familial outbreaks of the infection. METHODS: We studied four members of two families who contracted sporotrichosis after sleeping in an old and rust-stained camping tent. RESULTS: All cases presented with polymorphic lesions, three of them with multiple sites of inoculation. The camping tent was shown to be the source of infection. CONCLUSIONS: We report an epidemic of sporotrichosis in a family. In three cases disseminated cutaneous sporotrichosis occurred in nonimmunodeficient patients. The isolate of Sporothrix schenckii from a camping tent is extremely rare.

Adult↗
PubMed1998

Epidemic cutaneous sporotrichosis: report of 16 cases in Queensland due to mouldy hay.

We report an epidemic of sporotrichosis in a south-east Queensland rural community. Sporotrichosis is a fungal infection due to the organism Sporothrix schenckii, typically presenting with cutaneous lesions. Sixteen cases of cutaneous sporotrichosis were seen over a 9 month period in the Darling Downs region of Queensland. All patients had had contact with a batch of mouldy hay presumed to be contaminated by Sporothrix schenckii. Nine of 16 patients were male; the youngest patient was aged 11 and the oldest was 67 years of age. Lymphocutaneous sporotrichosis was seen in 50% of patients; the rest demonstrated the fixed cutaneous form. No cases of disseminated cutaneous or systemic sporotrichosis were seen. One case demonstrated lymphangitis related to sporotrichosis. No apparent difference in the duration to diagnosis was demonstrated to exist between lymphocutaneous or fixed cutaneous types.

Adolescent↗
PubMed1986

Metabolic activity of phagocytes in experimental sporotrichosis.

Phagocytosis plays an important role as a protective mechanism against infections, since polymorphonuclear leukocytes (PMN) and macrophages are the first cellular lines opposed to aggressive microorganisms. In patients with sporotrichosis a diminished capability of killing engulfed yeast by their PMN has been described, but the origin of this deficiency remains unknown. In this work, partial aspects of the oxidative metabolism of PMN leukocytes and peritoneal macrophages of mongolian gerbils experimentally infected with sporotrichosis were studied. For this purpose the nitroblue tetrazolium (NBT) test as described by Baehner and Nathan (1) and myeloperoxidase activity measured according to Kaplow's method were utilized. The PMN and macrophages of mongolian gerbils infected with sporotrichosis showed increased reduction of NBT when compared with the phagocytic cells of normal ones, as is usually observed in most infections. Myeloperoxidase activity was diminished in both PMN and macrophages, but this diminution was statistically significant only in PMN leukocytes. These results show that part of the oxidative mechanisms of phagocytic cells can be impaired in experimental sporotrichosis, and could be correlated with the diminished fungicidal activity of PMN leukocytes obtained from patients infected with sporotrichosis.

Animals↗
PubMed2003

Sporotrichosis with widespread cutaneous lesions: report of 24 cases related to transmission by domestic cats in Rio de Janeiro, Brazil.

BACKGROUND: Sporotrichosis most commonly presents as a localized lymphocutaneous infection following traumatic inoculation of soil, vegetables or organic substrates contaminated with the dimorphic fungus Sporothrix schenckii. Cases of widespread cutaneous lesions are rare. There have been isolated reports of household outbreaks of sporotrichosis involving cats and humans. METHODS: We report 24 cases of culture-proven sporotrichosis presenting with widespread cutaneous lesions. RESULTS: These 24 cases are part of an epidemic currently occurring in Rio de Janeiro. All patients reported contact with cats with sporotrichosis and 17 reported a history of a scratch or bite. Clinical manifestations included fixed lesions at multiple anatomical sites, and fixed lesions associated with the lymphocutaneous, bilateral lymphocutaneous and mucosal forms of the disease. Two patients were alcoholics and one patient was diabetic, while the remaining patients did not present any immunosuppressing condition. All patients responded to treatment with itraconazole. CONCLUSIONS: The domestic cat has played an important role in the transmission of sporotrichosis in Rio de Janeiro and seems to have contributed to this unusual clinical manifestation.

Adult↗
PubMed2000

Sporotrichosis in Peru: description of an area of hyperendemicity.

Sporotrichosis is a sporadic and rare mycotic infection in most of the developed world. In many parts of the developing world, sporotrichosis is much more commonly recognized, but epidemiological data are generally lacking from these regions. We report epidemiological, clinical, and treatment data from 238 cases of culture-proven sporotrichosis occurring in a relatively remote area of the south central highlands of Peru that were retrospectively collected during 1995-1997. Most cases (60%) occurred in children aged </=14 years, and the most commonly affected anatomic site was the face. Disease was clinically confined to the skin and subcutaneous tissue in all patients. The incidence of sporotrichosis in this region ranged from 48 to 60 cases per 100,000 persons and was highest among children aged 7-14 years, approaching 1 case per 1000 persons. Sporotrichosis is a significant mycosis in the rural highlands of Peru, with an incidence exceeding those of other invasive mycoses in individuals without human immunodeficiency virus infection.

Adolescent↗
PubMed2004

Cat-transmitted sporotrichosis epidemic in Rio de Janeiro, Brazil: description of a series of cases.

Sporotrichosis is the most common subcutaneous mycosis in South America. Classic infection is associated with traumatic inoculation of soil, vegetables, and organic matter contaminated with Sporothrix schenckii. Zoonotic transmission has been described in isolated cases or in small outbreaks. Since 1998, we have been observing an increasing number of cases of sporotrichosis in persons from the city of Rio de Janeiro, Brazil, and surroundings. From 1998 to 2001, 178 cases of culture-proven sporotrichosis had been diagnosed. Female patients predominated, and the median age was 39 years. The most frequent clinical presentation was lymphocutaneous disease. Of the 178 patients, 156 reported domiciliary or professional contact with cats with sporotrichosis, and 97 of these patients had a history of receipt of cat scratch or bite. The patients received itraconazole as first-line treatment. This study suggests that feline transmission of sporotrichosis was associated with a large and long-lasting outbreak of the disease in Rio de Janeiro.

Adolescent↗