Sporotrichosis

Abstract Sporotrichosis is a chronic pyogranulomatous infection caused by the thermally dimorphic fungus Sporothrix schenckii. Infection is usually limited to the skin and subcutaneous tissues, but can involve virtually any organ in its disseminated form. Less common localized forms of sporotrichosis include arthritis, osteomyelitis, meningitis, chronic pulmonary infection, and ocular disease. Schenck originally described sporotrichosis in 1898 in a 36-year old man who presented with several discrete indurated lesions extending along the lymphatics from the index finger proximally to the forearm. The organism obtained from cultures of the purulent drainage from one of these lesions revealed heavy growth of a moderately rapidly growing fungus that he designated as possibly related to Sporotrichum spp. (Schenck, 1898). Subsequently, investigators reported a second case of sporotrichosis in a 5-year-old boy with chronic ulceration of the index finger and associated nodular lymphangitis of the forearm (Hektoen and Perkins, 1900). Treatment entailed serial incision and drainage of each subcutaneous nodule followed by local wound care resulting in eventual full recovery. The fungus isolated from this young patient was referred to as Sporothrix schenckii. However, the more common designation, Sporotrichum schenckii, was used through the late 1960s until Carmichael’s observation that the organism had a different manner of sporulation when compared to Sporotrichum spp., and the name Sporothrix schenckii was officially readopted (Carmichael, 1962). After the initial description of sporotrichosis, most early cases were reported from France. One of the case reviews from France involved approximately 250 patients with sporotrichosis and remains one of the largest reports of this condition to date (de Beurman and Gougerot, 1912). As knowledge of the disease became more widespread, fewer cases were identified in Europe and cases of sporotrichosis began to be reported world-wide, with the abundance of cases emerging from the United States, Mexico, and South America.