Sporotrichosis is a fungal infection caused by the dimorphic fungus Sporothrix schenckii (Figure). It has a worldwide distribution and is associated with soil, vegetation, and wood.
Disease most commonly results from traumatic inoculation, which leads to infection of the skin and adjacent lymphatics. Pulmonary disease is presumed to occur via inhalation. Dissemination to or inoculation at other sites, including bones, joints, and the CNS, also occurs, although rarely.1
While person-to-person spread does not occur, zoonotic transmission involving cats as well as digging animals, such as armadillos, has been documented.2 Risk factors for serious disease include alcoholism and immunosuppression, such as that seen in patients with AIDS.3-6
1. Kauffman CA. Sporotrichosis. In: Hospenthal DR, Rinaldi MG, eds. Diagnosis and Treatment of Human Mycoses. Totowa, NJ: Humana Press; 2008:343-354.
2. Barros MB, Schubach Ade O, do Valle AC, et al. Cat-transmitted sporotrichosis epidemic in Rio de Janeiro, Brazil: description of a series of cases. Clin Infect Dis. 2004;38:529-535.
3. Sharkey-Mathis PK, Kauffman CA, Graybill JR, et al. Treatment of sporotrichosis with itraconazole. NIAID Mycoses Study Group. Am J Med. 1993;95:279-285.
4. Kauffman CA, Pappas PG, McKinsey DS, et al. Treatment of lymphocutaneous and visceral sporotrichosis with fluconazole. Clin Infect Dis. 1996;22:46-50.
5. Wroblewska M, Swoboda-Kopec E, Kawecki D, et al. Infection by a dimorphic fungus Sporothrix schenckii in an immunocompromised patient. Infection. 2005;33:289-291.
6. Oscherwitz SL, Rinaldi MG. Disseminated sporotrichosis in a patient infected with human immunodeficiency virus. Clin Infect Dis. 1992;15: 568-569.
7. Kauffman CA, Hajjeh R, Chapman SW; Mycoses Study Group; Infectious Diseases Society of America. Practice guidelines for the management of patients with sporotrichosis. Clin Infect Dis. 2000;30:684-687.
8. Kauffman CA, Bustamante B, Chapman SW, Pappas PG; Infectious Diseases Society of America. Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007;45:1255-1265.
9. Terrell CL. Antifungal agents. Part II. The azoles. Mayo Clin Proc. 1999;74:78-100.
10. Alvarado-Ramirez E, Torres-Rodríguez JM. In vitro susceptibility of Sporothrix schenckii to six antifungal agents determined using three different methods. Antimicrob Agents Chemother. 2007; 51:2420-2423.
11. Marimon R, Serena C, Gené J, et al. In vitro antifungal susceptibilities of five species of sporothrix. Antimicrob Agents Chemother. 2008;52:732-734.
12. McGinnis MR, Nordoff N, Li RK, et al. Sporothrix schenckii sensitivity to voriconazole, itraconazole and amphotericin B. Med Mycol. 2001;39:369-371.
13. Cabezas C, Bustamante B, Holgado W, Begue RE. Treatment of cutaneous sporotrichosis with one daily dose of potassium iodide. Pediatr Infect Dis J. 1996;15:352-354.
14. Chen SC, Sorrell TC. Antifungal agents. Med J Aust. 2007;187:404-409.
15. Chapman SW, Pappas P, Kauffman C, et al. Comparative evaluation of the efficacy and safety of two doses of terbinafine (500 and 1000 mg day(-1)) in the treatment of cutaneous or lymphocutaneous sporotrichosis. Mycoses. 2004;47: 62-68.
16. da Rosa AC, Scroferneker ML, Vettorato R, et al. Epidemiology of sporotrichosis: a study of 304 cases in Brazil. J Am Acad Dermatol. 2005;52(3 pt 1):451-459.
17. Mahajan VK, Sharma NL, Sharma RC, et al. Cutaneous sporotrichosis in Himachal Pradesh, India. Mycoses. 2005;48:25-31.
18. Winn RE, Anderson J, Piper J, et al. Systemic sporotrichosis treated with itraconazole. Clin Infect Dis. 1993;17:210-217.
19. Pluss JL, Opal SM. Pulmonary sporotrichosis: review of treatment and outcome. Medicine (Baltimore). 1986;65:143-153.
20. Silva-Vergara ML, Maneira FR, De Oliveira RM, et al. Multifocal sporotrichosis with meningeal involvement in a patient with AIDS. Med Mycol. 2005;43:187-190.
21. Gottlieb GS, Lesser CF, Holmes KK, Wald A. Disseminated sporotrichosis associated with treatment with immunosuppressants and tumor necrosis factor-alpha antagonists. Clin Infect Dis. 2003;37:838-840.
22. Pursley TJ, Blomquist IK, Abraham J, et al. Fluconazole-induced congenital anomalies in three infants. Clin Infect Dis. 1996;22:336-340.
23. American Academy of Pediatrics. Recommended doses of parenteral and oral antifungal drugs. In: Pickering LK, Baker CJ, Long SS, McMillan JA, eds. Red Book. 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006: 777-779.