A chronic skin infection, caused by a fungus which may become a
widespread (disseminated, systemic) infection, particularly in people with weakened immune
Causes of Sporotrichosis
Sporotrichosis is caused by the fungus Sporothrix schenckii, which is found in
vegetation. Infection commonly occurs when the skin is broken while handling plant
materials such as rosebushes, briars, or mulch-rich dirt.
Sporotrichosis can be an occupational disease (for farmers, horticulturists, rose
gardeners, plant nursery workers). Widespread (disseminated) sporotrichosis can develop in
immunocompromised people when they inhale spore-laden dust.
Symptoms include a small, painless, red lump that develops at the site of infection and
ultimately develops into an ulcer. Lesions are often on the hands and forearm, as these
areas are a common site of injury.
The organism follows the lymph flow causing small ulcers to appear in lines on the skin as
the infection progresses up the arm (or leg). These lesions do not heal unless treated and
may remain ulcerated for years.
Systemic sporotrichosis can cause lung and breathing problems, osteomyelitis, arthritis,
Description of Sporotrichosis
The fungus that causes sporotrichosis is found in spagnum moss, soil, and rotting
vegetation. Anyone can get sporotrichosis, but it is most common among nursery workers,
farm laborers, and gardeners handling spagnum moss, roses, or barberry bushes. Cases have
also been reported in workers whose jobs took them under houses into crawl spaces
contaminated with the fungus. Children who played on baled hay have also gotten the
disease. Sporotrichosis is sometimes called spagnum moss disease or alcoholic rose
Symptoms of Sporotrichosis
- Small, painless, red lump that develops at site of a recent injury (up to 3 months
- A progressive line of ulcers leading away from the initial ulcer.
The fungus causing sporotrichosis enters the body through scratches or cuts in the
skin. Therefore, people who handle plants with sharp thorns or needles, like roses,
barberry, or pines, are more likely to get sporotrichosis. Sporotrichosis is not passed
directly from person to person, so it is not possible to catch sporotrichosis from another
person who has it.
The first signs of sporotrichosis are painless pink, red, or purple bumps usually on
the finger, hand, or arm where the fungus entered the body. These bumps may appear
anywhere from one to twelve weeks after infection, but usually appear within three weeks.
Unlike many other fungal infections sporotrichosis does not cause fever or any feelings of
general ill health.
The reddish bumps eventually expand and fester, creating skin ulcers that do not heal.
In addition, the infection often moves to nearby lymph nodes. Although most cases of
sporotrichosis are limited to the skin and lymph channels, occasionally the joints, lungs,
and central nervous system become infected. In rare cases, death may result.
People who have weakened immune systems, either from a disease such as Acquired Immune
Deficiency Syndrome (AIDS) or leukemia, or as the result of medications they take
(corticosteroids, chemotherapy drugs), are more likely to get sporotrichosis and are more
at risk for the disease to spread to the internal organs. Alcoholics and people with
diabetes mellitus or a pre-existing lung disease are also more likely to become infected.
Although sporotrichosis is painless, it is important for people with symptoms to see a
doctor and receive treatment.
Diagnosis of Sporotrichosis
The preferred way to diagnose sporotrichosis is for a doctor to obtain a sample of
fluid from a freshly opened sore and send it to a laboratory to be cultured. The procedure
is fast and painless. It is possible to confirm the presence of advanced sporotrichosis
through a blood test or a biopsy. Doctors may also take a blood sample to perform tests
that rule out other fungal infections or diseases such as tuberculosis or bacterial
Dermatologists and doctors who work with AIDS patients are more likely to have
experience in diagnosing sporotrichosis. In at least one state, New York, the laboratory
test to confirm this disease is provided free through the state health department. In
other cases, diagnosis should be covered by health insurance at the same level as other
diagnostic laboratory tests.
Treatment of Sporotrichosis
When sporotrichosis is limited to the skin and lymph system, it is usually treated with
a saturated solution of potassium iodine that the patient dilutes with water or juice and
drinks several times a day. The iodine solution can only be prescribed by a physician.
This treatment must be continued for many weeks. Skin ulcers should be treated like any
open wound and covered with a clean bandage to prevent a secondary bacterial infection.
The drug itraconazol (Sporanox), taken orally, is also available to treat sporotrichosis.
In serious cases of sporotrichosis, when the internal organs are infected, the
preferred treatment is the drug amphotericin B. Amphotericin B is a strong anti-fungal
drug with potentially severe toxic side effects. It is given intravenously, so
hospitalization is required for treatment. The patient may also receive other drugs to
minimize the side effects of the amphotericin B.
Alternative treatment of Sporotrichosis
Alternative treatment for fungal infections focuses on maintaining general good health
and eating a diet low in dairy products, sugars, including honey and fruit juice, and
foods, such as beer, that contain yeast. This is complemented by a diet high in raw food.
Supplements of and vitamins C, E, and A, B complex, and pantothenic acid may also be added
to the diet, as may Lactobacillus acidophilus, bifidobacteria, and garlic capsules.
Fungicidal herbs such as myrrh (Commiphora molmol), tea tree oil (Melaleuca
spp.), citrus seed extract, pau d'arco tea, and garlic (Allium sativum) may also be
applied directly to the infected skin.
Prognosis of Sporotrichosis
Most cases of sporotrichosis are confined to the skin and lymph system. With treatment,
skin sores begin healing in one to two months, but complete recovery often takes six
months or more. People who have AIDS are also more likely to have the fungus spread
throughout the body, causing a life-threatening infection. In people whose bones and
joints are infected or who have pulmonary lesions, surgery may be necessary.
Prevention of Sporotrichosis
Since an opening in the skin is necessary for the sporotrichosis fungus to enter the
body, the best way to prevent the disease is to avoid accidental scrapes and cuts on the
hands and arms by wearing gloves and long sleeves while gardening. Washing hands and arms
well after working with roses, barberry, spagnum moss, and other potential sources of the
fungus may also provide some protection