Sporotrichosis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alison Leibowitz [2]
Overview
Symptoms of cutaneous sporotrichosis include nodular lesions on the skin, at the point of inoculation, as well as along lymph nodes and vessels. The lesion is initially small and painless, and ranges in color from pink to purple. Left untreated, the lesion becomes larger, ulcerates, and oozes. Typically, cutaneous sporotrichosis lesions manifest in the upper extremities. Extracutaneous forms of sporotrichosis typically manifest with a broad range of unspecific clinical symptoms, frequently resulting in delayed diagnosis.
Forms and symptoms
Cutaneous (or skin) sporotrichosis
Symptoms of this form include nodular lesions or bumps in the skin, at the point of entry and also along lymph nodes and vessels. The lesion starts off small and painless, and ranges in color from pink to purple. Left untreated, the lesion becomes larger and looks similar to a boil and more lesions may appear, until a chronic ulcer develops. Usually, cutaneous sporotrichosis lesions occur in the finger, hand, and arm.
Fixed form:
- Staying localized within the subcutaneous tissue, the fungus transforms into its yeast form.
- Manifests at the site of inoculation with at least one, frequently ulcerated, lesion. The lesions are characterized by red edges due to capillary dilation and congestion
- Fixed form sporotrichosis may spontaneously regress.
- Fixed form sporotrichosis is the main clinical presentation in child patients.[1]
Lymphocutaneous form
- This is the most common form of sporotrichosis, making up about 70% of cases.
- Secondary lesions manifest along the adjacent lymphatic pathway.
- The presence of systematic symptoms is rare.[2]
Extracutaneous/Systemic Sporotrichosis
Osteoarticular form
- Most common extracutaneous form of sporotrichosis
- Usually begins as monoarticular disease without associated systemic illness
- May manifest by contiguity or hematogenous spread. Characterized by the involvement of bones and joints
- Usually affects joints in the knee, wrist, elbow, and ankle
- May manifest with tenosynovitis or bursitis
- Frequently associated with arthritis. In these cases of coexisting diagnoses, lesions typically manifest along bones adjacent to affected joints.
Pulmonary sporotrichosis
- This rare form of the disease occurs when S. schenckii spores are inhaled.
- Symptoms of pulmonary sporotrichosis include productive coughing, nodules and cavitations of the lungs, fibrosis, and swollen hilar lymph nodes.
- Patients with this form of sporotrichosis are susceptible to developing tuberculosis and pneumonia.[3]
Disseminated sporotrichosis
- When the infection spreads from the primary site to secondary sites in the body, the disease develops into a rare and critical form called disseminated sporotrichosis. The infection can spread to joints and bones (called osteoarticular sporotrichosis) as well as the central nervous system and the brain (called sporotrichosis meningitis).
- The symptoms of disseminated sporotrichosis include weight loss, anorexia, and appearance of bony lesions.[4]
Sporotrichosis in animals
Sporotrichosis can be diagnosed in domestic and wild mammals. In veterinary medicine it is most frequently seen in cats and horses. Cats have a particularly severe form of cutaneous sporotrichosis and also can serve as a source of zoonotic infection to persons who handle them and are exposed to exudate from skin lesions.
References
- ↑ Barros MB, de Almeida Paes R, Schubach AO (2011). "Sporothrix schenckii and Sporotrichosis". Clin Microbiol Rev. 24 (4): 633–54. doi:10.1128/CMR.00007-11. PMC 3194828. PMID 21976602.
- ↑ Bonifaz A, Saúl A, Paredes-Solis V, Fierro L, Rosales A, Palacios C; et al. (2007). "Sporotrichosis in childhood: clinical and therapeutic experience in 25 patients". Pediatr Dermatol. 24 (4): 369–72. doi:10.1111/j.1525-1470.2007.00452.x. PMID 17845157.
- ↑ Ramirez J, Byrd RP, Roy TM (1998). "Chronic cavitary pulmonary sporotrichosis: efficacy of oral itraconazole". J Ky Med Assoc. 96 (3): 103–5. PMID 9529831.
- ↑ Alvarado-Ramírez E, Torres-Rodríguez JM (2007). "In vitro susceptibility of Sporothrix schenckii to six antifungal agents determined using three different methods". Antimicrob Agents Chemother. 51 (7): 2420–3. doi:10.1128/AAC.01176-06. PMC 1913275. PMID 17438048.