infectious diseases
Sporotrichosis
Symptoms and Signs of Sporotrichosis
Lymphocutaneous infections are most common. They characteristically involve one hand and arm, although they can occur anywhere on the body; primary lesions may occur on exposed surfaces of the feet or face. A primary lesion may appear as a small, nontender papule or, occasionally, as a slowly expanding subcutaneous nodule that eventually becomes necrotic and sometimes ulcerates. Typically, a few days or weeks later, a chain of lymph nodes that drain the affected area begins to enlarge slowly but progressively, forming movable subcutaneous nodules. Without treatment, overlying skin reddens and may later necrose, sometimes causing an abscess, ulceration, and bacterial superinfection. Systemic symptoms and signs of infection are notably absent. Sporotrichosis starts as a small papule or subcutaneous nodule that may ulcerate or necrose. Image courtesy of www.doctorfungus.org © 2005. Sporotrichosis starts as a small papule or subcutaneous nodule that may ulcerate or necrose. Image courtesy of www.doctorfungus.org © 2005. Sporotrichosis starts as a small papule or subcutaneous nodule that may ulcerate or necrose. The infection spreads lymphatically. If untreated, diffuse erythema, ulcers, and abscesses may develop as is seen in this example of severe bacterial superinfection. Image courtesy of Dr. Lucille Georg via the Public Health Image Library of the Centers for Disease Control and Prevention. This photo shows cutaneous nodules in a lymphangitic (sporotrichoid) distribution over the dorsum of the right hand. Image courtesy of Karen McKoy, MD. Lymphocutaneous sporotrichosis is chronic and indolent; it is potentially fatal only if bacterial superinfections cause sepsis. Rarely, in patients without primary lymphocutaneous lesions, hematogenous spread leads to indolent infections of multiple peripheral joints, sometimes bones, and, less often, genitals, liver, spleen, kidneys, or meninges. These infections are more common among patients with immunocompromise due to another disorder (eg, alcohol use disorder). Equally rare is chronic pneumonia caused by inhaling spores and manifested by localized infiltrates or cavities, most often in patients with preexisting chronic lung disease. 