Lymphocutaneous sporotrichosis is a subcutaneous fungal infection caused by Sporothrix schenckii complex species. This infection primarily affects the skin and lymphatic system, often following minor trauma involving plant material. It is commonly seen in gardeners, florists, and individuals handling organic matter.
Causes and Transmission
The primary cause of lymphocutaneous sporotrichosis is infection with Sporothrix schenckii, a dimorphic fungus found in soil, plants, decaying vegetation, and sphagnum moss. The infection is acquired through:
- Trauma to the skin (e.g., thorns, splinters, scratches from infected cats)
- Zoonotic transmission, particularly from infected cats through bites or scratches
- Inhalation (rare cases) leading to pulmonary sporotrichosis
Symptoms of Lymphocutaneous Sporotrichosis
The infection progresses in stages:
- Initial Lesion – A painless, small nodule appears at the site of inoculation within 1 to 12 weeks.
- Lymphatic Spread – Secondary nodules form along the lymphatic vessels, ulcerating and discharging pus.
- Chronic Phase – Lesions persist for weeks to months if untreated, with potential secondary bacterial infections.
Diagnosis
Accurate diagnosis involves:
- Clinical Examination – Identifying nodular lesions following a lymphatic pattern.
- Fungal Culture – Growth of Sporothrix schenckii from pus, biopsy, or swabs.
- Histopathology – Shows cigar-shaped yeast forms in tissue samples.
- Molecular Tests – PCR-based identification of Sporothrix species.
Treatment Options
Antifungal Therapy
- First-Line Treatment: Itraconazole (100-200 mg/day for 3-6 months)
- Severe Cases: Amphotericin B for disseminated infections
- Alternative: Potassium iodide (KI) in resource-limited settings
Supportive Care
- Proper wound care to prevent bacterial superinfection
- Pain management with NSAIDs
- Avoidance of further exposure to fungal sources
Prevention Strategies
- Protective Clothing: Gloves and long sleeves when handling plants or soil
- Proper Wound Care: Immediate cleaning of skin injuries
- Animal Handling Precautions: Avoid contact with infected cats
- Environmental Control: Reducing exposure to contaminated soil and plant materials
Lymphocutaneous sporotrichosis is a treatable fungal infection with a well-defined clinical course. Early recognition and antifungal therapy ensure effective recovery. Protective measures can significantly reduce the risk of infection, particularly for at-risk individuals.
