Sporotrichosis - Specialists and Information

Sporotrichosis is caused by the fungus Sporothrix schenckii. Recent research findings show that other Sporothrix species can also cause the infection.

Sporotrichosis is caused by the fungus Sporothrix @ Dr_Microbe /AdobeStock

The disease progresses similarly in all cases. It usually begins when the fungus is forced under the skin by a rose thorn or a sharp branch.

Sporotrichosis occurs when injured skin comes into contact with hay or soil containing the fungus. Farmers, nursery workers, gardeners, and landscapers are at higher risk of contracting sporotrichosis.

People with weakened immune systems (such as those with HIV or cancer) are also at increased risk for sporotrichosis.

Animals, such as cats, can also transmit sporotrichosis to humans through scratch wounds.

In very rare cases, infection can occur through ingestion or inhalation of the fungus. However, this type of transmission usually occurs in people with weakened immune systems.

Human-to-human transmission is not possible. Sporothrix schenckii is dimorphic (yeast- or hyphae-like). In recent years, veterinarians have increasingly diagnosed sporotrichosis in pets, particularly in horses and cats. 

Cats develop a particularly contagious form of the disease. People who treat this infection are at high risk of also contracting sporotrichosis through a zoonotic infection.

Work gloves and sturdy boots as a preventive measure against sporotrichosis @ encierro /AdobeStock

It can take anywhere from days to months after transmission for sporotrichosis to develop. The first symptom is a small bump or firm lump with a pink or purple color. The lump is usually painless, at most accompanied by a slight pulling sensation. Over time, this bump develops into a large, open wound from which fluid oozes.

In other cases of sporotrichosis, mycetomas form. These are skin tumors that lead to more severe inflammation. If doctors do not treat these symptoms, they can become chronic and persist unchanged for years.

In 60 percent of cases, the fungus spreads through the lymphatic system. This results in more and more sores and swellings in the affected area. This condition can drag on for years.

In very rare cases of sporotrichosis, the disease can spread to other parts of the body. It can affect bones, joints, lungs, and brain tissue. Infection via the respiratory tract leads to severe whooping cough. 

People who become infected with sporotrichosis in this way may develop tuberculosis and pneumonia. This typically occurs in individuals with weakened immune systems. The spread of sporotrichosis can then be life-threatening and is difficult to treat.

At first, the symptoms are barely noticeable. But over time, the inflammation spreads and spreads like a web across the affected part of the body.

If you suspect you have sporotrichosis, you should see a doctor to receive a professional diagnosis and treatment. Individuals who are already ill should always see a doctor immediately if their symptoms worsen and/or new ulcers appear. 

Sporotrichosis does not normally pose an acute threat to life or limb. However, open ulcers can become infected with bacteria, leading to unusual symptoms. Therefore, if you experience a rapid rise in temperature, pain, or redness around the ulcers, you should go to the emergency room.

There are a number of infections similar to sporotrichosis. Therefore, a doctor will perform various tests to confirm the diagnosis. 

This usually includes a biopsy (removal of tissue) from an infected lesion. The tissue is then examined by a laboratory to identify the pathogen. 

Infections that are easily confused with sporotrichosis include: 

• Bacteria related to tuberculosis and leprosy
• Cowpox
• Herpes
• Other fungal infections such as candidiasis, histoplasmosis, tinea capitis, or blastomycosis
• Non-infectious diseases such as lupus or sarcoidosis

Specialists can distinguish the causative fungus from other pathogens by isolating it and examining its structure.

Another form of diagnosis involves detecting antibodies. People with sporotrichosis develop antibodies against the pathogen Sporothrix schenckii. This diagnosis is not considered definitive.

There is no effective self-treatment for sporotrichosis. You should keep the sores clean and covered until they heal. Medical treatment depends on the infected area of the body and the patient’s overall health.

• Sporotrichosis of the Skin

Doctors treat this form with a saturated potassium iodide solution. The medication must be taken three times a day for a period of three to six months. Treatment continues until the ulcers have healed. Doctors also treat skin infections with itraconazole. This treatment also lasts up to six months.

• Sporotrichosis in the bones and joints

This form of the infection is more difficult to treat, as a potassium iodide solution is largely ineffective. Itraconazole is sometimes used, even for up to a year. 

In severe cases, doctors prescribe the drug amphotericin. Amphotericin has more severe side effects than other medications, and treatment takes a long time. Another option is the surgical removal of the infected bones.

• Sporotrichosis in the Lungs

Doctors also treat sporotrichosis in the lungs with potassium iodide solution, itraconazole, or amphotericin. Success rates vary widely. As a result, partial removal of lung tissue may be necessary.

• Sporotrichosis of the brain

Sporotrichosis meningitis is very rare, and there is no information on a standardized treatment. Treatment with amphotericin combined with 5-fluorocytosine is recommended. Itraconazole is also effective in these cases.

• Sporotrichosis During Pregnancy

Neither potassium iodide solution nor itraconazole should be used in pregnant women. Pregnant women with sporotrichosis must consult an infectious disease specialist and receive treatment from that specialist.

If treatment for sporotrichosis has been successful, a few follow-up visits to the treating physician are usually necessary. The physician will ensure that the infection has completely resolved. Further treatment is then normally not necessary.

The most effective prevention is to keep spores and pathogens from entering the skin and the body. People who work with roses, soil, hay, moss, or twigs should cover any cuts or wounds on their skin. 

They should also wear heavy boots and sturdy work gloves to prevent pricks or other wounds.

People with weakened immune systems must be cautious when handling roses, hay, soil, moss, or twigs. They are more likely to contract sporotrichosis and are less able to fight off the disease.

Most people with sporotrichosis make a full recovery if they receive the proper treatment. Long-term complications are possible; these can range from very mild to very serious if proper treatment is not administered in a timely manner. 

Symptoms may then persist for several years. The ulcers can form deep scars that remain long-term. 

Sporotrichosis affecting the brain, bones, joints, or lungs is more difficult to treat. If organs or bones are infected, surgery may be necessary.