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Sporotrichosis
Aka: Sporotrichosis, Sporothrix schenckii
- Pathophysiology
- Saprophytic, Dimorphic fungus
- Prototypal example of Nodular Lymphangitis
- Exposure risks
- Soil or plant debris
- Thorns
- Sphagnum moss
- Timber
- Animal Bites or scratches
- Signs
- Primary lesion after 1-12 week incubation
- Nodular lesion develops at site of inoculation
- Secondary lesions
- Erythematous Papules, Nodules develop up lymph chain
- Lesions ulcerate and drain clear serous fluid
- Other findings
- Rarely fever or regional adenopathy occur
- Differential Diagnosis
- See Nodular Lymphangitis
- Labs
- Routine fluid culture negative
- Culture of biopsied tissue shows saprophytic fungi
- Management
- Apply warm compresses for 40 to 60 minutes per day
- Antifungal for 2 months after lesion resolution
- Itraconazole 200 mg PO qd (preferred)
- Terbinafine (Lamisil) 250 mg PO bid
- SSKI 5 drops PO tid (titrated to 40-50 drops tid)
- References
- Kauffman (1995) Clin Infect Dis 21:981-5 [PubMed]
- Tobin (2001) Am Fam Physician 63(2):326-32 [PubMed]