Sporotrichosis is a chronic granulomatous mycotic
infection caused by Sporothrix schenckii, a common saprophyte of soil, decaying wood, hay, and sphagnum moss, that is endemic in tropical/subtropical areas. The recent phylogenetic studies have delineated the geographic distribution of multiple distinct Sporothrix species causing
sporotrichosis. It characteristically involves the skin and subcutaneous tissue following traumatic inoculation of the pathogen. After a variable incubation period, progressively enlarging papulo-nodule at the inoculation site develops that may ulcerate (fixed cutaneous
sporotrichosis) or multiple nodules appear proximally along lymphatics (lymphocutaneous
sporotrichosis). Osteoarticular
sporotrichosis or primary pulmonary
sporotrichosis are rare and occur from direct inoculation or inhalation of conidia, respectively. Disseminated cutaneous
sporotrichosis or involvement of multiple visceral organs, particularly the central nervous system, occurs most commonly in persons with immunosuppression. Saturated
solution of
potassium iodide remains a first line treatment choice for uncomplicated cutaneous
sporotrichosis in resource poor countries but
itraconazole is currently used/recommended for the treatment of all forms of
sporotrichosis.
Terbinafine has been observed to be effective in the treatment of cutaneous
sporotrichosis.
Amphotericin B is used initially for the treatment of severe, systemic disease, during pregnancy and in immunosuppressed patients until recovery, then followed by
itraconazole for the rest of the
therapy.