SPOROTRICHOSIS

Diagnosis: SPOROTRICHOSIS

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted May 13, 2009.

Treatment

See case discussion.

Differential Diagnosis

• Mycobacterial infection (M. marinum, M. kansasii) • Nocardiosis • Leishmaniasis • Tularemia • Cat scratch disease • Foreign body granuloma • Cutaneous lymphoma

Key Learnings

• Caused by dimorphic fungus Sporothrix schenckii — classic zoonosis from soil/plant material • Classic lymphocutaneous pattern: inoculation chancriform nodule → linear nodules along lymphatic drainage • "Rose gardener's disease" — classic exposure history • Mnemonic for sporotrichoid spread: "five L's" — Leishmaniasis, Leprosy, Lupus vulgaris (TB), Lymphoma, and fungi (Sporothrix, NTM) • Culture on Sabouraud agar at 25°C: star-shaped colonies • Itraconazole is the treatment of choice for cutaneous/lymphocutaneous disease • Saturated solution of potassium iodide (SSKI) is a historical alternative treatment

Tags: sporotrichosis, dr.azeem alam khan