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Sporotrichosis

 
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Sporotrichosis is caused by Sporothrix schenckii and subspecies - a group of thermally dimorphic fungi that live as saprophytes on plants. Occupational exposure occurs in gardners, farmers, florists, landscaping workers, and agricultural/forest workers. The source of infection is plants (roses), mosses, hay, and animal skin surface.

The fungus enters via a cutaneous puncture or a small abrasion. The incubation period ranges from 3 days to several weeks. The lesion begins as a nodule or plaque at inoculation site, usually on hands, fingers, and extremities. They become red to purple and ulcerate with crusting. The lesions may extend proximally in a linear arrangement along the extremity.

Nodular lymphangiitis and lymphadenitis may develop. Pulmonary infection can occur with inhalational exposure resulting in cough and lesions on chest x-ray. In patients with weakened host defenses, disseminated infection may result from skin or pulmonary sites.

Cutanous or lymphocutaneous sporotrichosis is treated with itraconazole.

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