Sporotrichosis history and symptoms: Difference between revisions

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==Overview==
==Overview==
Symptoms of cutaneous sporotrichosis include nodular [[lesion]]s 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.  
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, [[Ulcerated lesion|ulcerates]], and oozes. Typically, cutaneous sporotrichosis [[Lesion|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==
==Forms and symptoms==
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'''Cutaneous (or skin) sporotrichosis'''
'''Cutaneous (or skin) sporotrichosis'''


Symptoms of this form include nodular [[lesion]]s 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 (dermatology)|ulcer]] develops. Usually, cutaneous sporotrichosis lesions occur in the finger, hand, and arm.
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 [[Lesion|lesions]] may appear, until a chronic [[ulcer]] develops. Usually, cutaneous sporotrichosis [[lesions]] occur in the finger, hand, and arm.


''Fixed form:''
''Fixed form:''
:*Staying localized within the subcutaneous tissue, the fungus transforms into its yeast 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.
:*Manifests at the site of [[inoculation]] with at least one, frequently [[Ulcerated lesion|ulcerated, lesion]]. The [[lesions]] are characterized by red edges due to [[capillary]] dilation and congestion.
:*Fixed form sporotrichosis may spontaneously regress.
:*Fixed form sporotrichosis may spontaneously regress.
:*Fixed form sporotrichosis is the main clinical presentation in child patients.<ref name="pmid21976602">{{cite journal| author=Barros MB, de Almeida Paes R, Schubach AO| title=Sporothrix schenckii and Sporotrichosis. | journal=Clin Microbiol Rev | year= 2011 | volume= 24 | issue= 4 | pages= 633-54 | pmid=21976602 | doi=10.1128/CMR.00007-11 | pmc=PMC3194828 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21976602  }} </ref>
:*Fixed form sporotrichosis is the main clinical presentation in child patients.<ref name="pmid21976602">{{cite journal| author=Barros MB, de Almeida Paes R, Schubach AO| title=Sporothrix schenckii and Sporotrichosis. | journal=Clin Microbiol Rev | year= 2011 | volume= 24 | issue= 4 | pages= 633-54 | pmid=21976602 | doi=10.1128/CMR.00007-11 | pmc=PMC3194828 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21976602  }} </ref>
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''Lymphocutaneous form''
''Lymphocutaneous form''
:*This is the most common form of sporotrichosis, making up about 70% of cases.
:*This is the most common form of sporotrichosis, making up about 70% of cases.
:*Secondary lesions manifest along the adjacent lymphatic pathway.
:*Secondary lesions manifest along the adjacent [[Lymphatic system|lymphatic pathway]].
:*The presence of systematic symptoms is rare.<ref name="pmid17845157">{{cite journal| author=Bonifaz A, Saúl A, Paredes-Solis V, Fierro L, Rosales A, Palacios C et al.| title=Sporotrichosis in childhood: clinical and therapeutic experience in 25 patients. | journal=Pediatr Dermatol | year= 2007 | volume= 24 | issue= 4 | pages= 369-72 | pmid=17845157 | doi=10.1111/j.1525-1470.2007.00452.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17845157  }} </ref>
:*The presence of systematic symptoms is rare.<ref name="pmid17845157">{{cite journal| author=Bonifaz A, Saúl A, Paredes-Solis V, Fierro L, Rosales A, Palacios C et al.| title=Sporotrichosis in childhood: clinical and therapeutic experience in 25 patients. | journal=Pediatr Dermatol | year= 2007 | volume= 24 | issue= 4 | pages= 369-72 | pmid=17845157 | doi=10.1111/j.1525-1470.2007.00452.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17845157  }} </ref>


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:*May manifest by contiguity or hematogenous spread. Characterized by the involvement of bones and joints.  
:*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.  
:*Usually affects joints in the knee, wrist, elbow, and ankle.  
:*May manifest with tenosynovitis or bursitis.  
:*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.
:*Frequently associated with [[arthritis]]. In these cases of coexisting diagnoses, lesions typically manifest along bones adjacent to affected joints.


''Pulmonary sporotrichosis''
''Pulmonary sporotrichosis''
:*This rare form of the disease occur when ''S. schenckii'' spores are inhaled.   
:*This rare form of the disease occur when ''S. schenckii'' spores are inhaled.   
:*Symptoms of [[pulmonary]] sporotrichosis include productive [[cough]]ing, nodules and cavitations of the lungs, [[fibrosis]], and swollen [[Hilum of lung|hilar]] [[lymph node]]s.   
:*Symptoms of [[pulmonary]] sporotrichosis include productive [[cough]]ing, [[Nodule (medicine)|nodules]] and cavitations of the lungs, [[fibrosis]], and swollen [[Hilum of lung|hilar]] [[lymph node]]s.   
:*Patients with this form of sporotrichosis are susceptible to developing [[tuberculosis]] and [[pneumonia]].<ref name="pmid9529831">{{cite journal| author=Ramirez J, Byrd RP, Roy TM| title=Chronic cavitary pulmonary sporotrichosis: efficacy of oral itraconazole. | journal=J Ky Med Assoc | year= 1998 | volume= 96 | issue= 3 | pages= 103-5 | pmid=9529831 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9529831  }} </ref>
:*Patients with this form of sporotrichosis are susceptible to developing [[tuberculosis]] and [[pneumonia]].<ref name="pmid9529831">{{cite journal| author=Ramirez J, Byrd RP, Roy TM| title=Chronic cavitary pulmonary sporotrichosis: efficacy of oral itraconazole. | journal=J Ky Med Assoc | year= 1998 | volume= 96 | issue= 3 | pages= 103-5 | pmid=9529831 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9529831  }} </ref>


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==Sporotrichosis in animals==
==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.
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==
==References==

Revision as of 15:56, 28 January 2016

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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

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

  1. 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.
  2. 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.
  3. 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.
  4. 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.