In today’s world, many types of fungal diseases arise due to evolution infact one of

them is Sporotrichosis. I am personally interested in this since it affects animals like

cats in which we love to cuddle to. It is fundamental that as cat owners, we would
know what diseases they have that they could pass on to humans.

This fungal disease usually affects the skin, although other rare forms can affect the
lungs, joints, bones, and even the brain. Because roses can spread the disease, it is
one of a few diseases referred to as rose-thorn or rose-gardeners' disease.

This disease is caused by the infection of the fungus Sporothrix schenckii. It is

naturally found in soil, hay, sphagnum moss, and plants, it usually affects farmers,
gardeners, and agricultural workers. It enters through small cuts and abrasions in the
skin to cause the infection. In case of sporotrichosis affecting the lungs, the fungal
spores enter through the respiratory pathways. Sporotrichosis can also be acquired
from handling cats with the disease; it is an occupational hazard for veterinarians.
Sporotrichosis progresses slowly - the first symptoms may appear 1 to 12 weeks
(average 3 weeks) after the initial exposure to the fungus. Serious complications can
also develop in patients who have a compromised immune system. It is a chronic
disease with slow progression and often subtle symptoms. It is difficult to diagnose, as
many other diseases share similar symptoms and therefore must be ruled out.

Patients with sporotrichosis will have antibody against the fungus S. schenckii,
however, due to variability in sensitivity and specificity, it may not be a reliable
diagnosis for this disease. The confirming diagnosis remains culturing the fungus from
the skin, sputum, synovial fluid, and cerebrospinal fluid.
Cats with sporotrichosis are unique in that the exudate from their lesions may contain
numerous organisms. This makes cytological evaluation of exudate a valuable
diagnostic tool in this species. Exudate is pyogranulomatous and phagocytic cells may
be packed with yeast forms. These are variable in size, but many are cigar-shaped.
There are however different Forms of Sporotrichosis, this would be:

• Cutaneous or skin sporotrichosis

This is the most common form of this disease. Symptoms of this form includes 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 look similar to a boil and more
lesions will appear, until a chronic ulcer develops. Usually, cutaneous sporotrichosis
lesions occur in the finger, hand, and arm.

• Pulmonary sporotrichosis
This rare form of the disease occur 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.
 • 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.

The majority of sporotrichosis cases occur when the fungus is introduced through a cut
or puncture in the skin while handling vegetation containing the fungal spores.
Prevention of this disease includes wearing long sleeves and gloves while working with
soil, hay bales, rose bushes, pine seedlings, and sphagnum moss.
Treatment of sporotrichosis depends on the severity and location of the disease. The
following are latest treatment options for this condition, updated 2007:

 For Cutaneous Sporotrichosis

itraconazole (200 mg orally daily) is recommended to be given for 2–4 weeks after
all lesions have resolved, usually a total of 3–6 months.
Patients who do not respond to treatment should be given a higher dosage of
itraconazole (200 mg twice daily; terbinafine at a dosage of 500 mg orally twice daily,
or SSKI initiated at a dosage of 5 drops (using a standard eyedropper) 3 times daily,
increasing as tolerated to 40–50 drops 3 times daily.
Fluconazole at a dosage of 400–800 mg daily should be used only if the patient
cannot tolerate other agents.
Local hyperthermia can be used for treating patients, such as pregnant and nursing
women, who have fixed cutaneous sporotrichosis and who cannot safely take any of
the previous regimens.

For Pulmonary Sporotrichosis

 For severe or life-threatening pulmonary sporotrichosis, amphotericin B, given as a
lipid formulation at 3–5 mg/kg daily, is recommended (B-III). Amphotericin B
deoxycholate, administered at a dosage of 0.7–1.0 mg/kg daily, could also be used.
After the patient has shown a favorable response to amphotericin B treatment,
therapy can be changed to itraconazole administered at a dosage of 200 mg orally
twice daily to complete a total of at least 12 months of therapy.
For less severe disease, itraconazole administered at a dosage of 200 mg orally
twice daily for at least 12 months is recommended.
Serum levels of itraconazole should be determined after the patient has been
receiving this agent for at least 2 weeks to ensure adequate drug exposure.
Surgery combined with amphotericin B therapy is recommended for localized
pulmonary disease.

For Disseminated (Systemic) Sporotrichosis

 Amphotericin B, given as a lipid formulation at a dosage of 3–5 mg/kg daily, is
recommended for treatment of disseminated sporotrichosis. Amphotericin B
deoxycholate, administered at a dosage of 0.7–1.0 mg/kg daily, could also be used but
was not preferred by the panel.
Itraconazole administered at a dosage of 200 mg twice daily is recommended as
step-down therapy after the patient responds to initial treatment with amphotericin B
and should be given to complete a total of at least 12 months of therapy.
 Serum levels of itraconazole should be determined after the patient has been
receiving this agent for at least 2 weeks to ensure adequate drug exposure.
 Life-long suppressive therapy with itraconazole administered at a dosage of 200 mg
daily may be required in patients with AIDS and other immunosuppressed patients if
immunosuppression cannot be reversed.

New published data show that terbinafine is effective in high doses and thus is now
recommended as a second-line therapy. In contrast to the earlier guidelines, the panel
preferred lipid formulations of amphotericin B over amphotericin B deoxycholate for
treatment of meningeal, disseminated, and severe pulmonary sporotrichosis.

“Most people with sporotrichosis do fine and can be treated by a primary care
physician,” said lead author Carol A. Kauffman, MD, FIDSA, of the University of
Michigan Medical School and the Ann Arbor Veterans Affairs Healthcare System.
“However, patients whose infections have reached the bones, joints, lungs, or central
nervous system are exceedingly difficult to treat.”

Although experts may seem to say that it is exceedingly difficult to treat, I believe that
there are no such things as incurables; there are only things for which man has not
found a cure.
Sporotrichosis
(An Article in MicroParasitology)

Submitted To:
Ms. Paz Baculi

Submitted By:
Ana Marie V. Busa
BSN II-C