Sporotrichosis is a fungal infection caused by a fungus called Sporothrix schenckii. It usually infects the skin.

Causes

Persons handling thorny plants, sphagnum moss, or baled hay are at increased risk of getting sporotrichosis. Outbreaks have occurred among nursery workers handling sphagnum moss, rose gardeners, children playing on baled hay, and greenhouse workers handling bayberry thorns contaminated by the fungus. A number of cases have recently occurred among nursery workers, especially workers handling sphagnum moss topiaries.

Risk Factors

The fungus can be found in sphagnum moss, in hay, in other plant materials, and in the soil. It enters the skin through small cuts or punctures from thorns, barbs, pine needles, or wires. It is not spread from person to person.

Symptoms

The first symptom is usually a small painless bump resembling an insect bite. It can be red, pink, or purple in color. The bump (nodule) usually appears on the finger, hand, or arm where the fungus first enters through a break on the skin. This is followed by one or more additional bumps or nodules which open and may resemble boils. Eventually lesions look like open sores (ulcerations) and are very slow to heal. The infection can spread to other areas of
the body.

Diagnosis

Sporotrichosis can be confirmed when a doctor obtains a swab or a biopsy of a freshly opened skin nodule and submits it to a laboratory for fungal culture.

Treatment

Sporotrichosis is generally treated with potassium iodide, taken by mouth in droplet form. A new drug, called itraconazole (Sporanox), is available for treatment, but experience with this drug is still limited. Treatment is often extended over a number of weeks, until the skin lesions are completely healed.

Prevention

Control measures include wearing gloves and long sleeves when handling wires, rose bushes, hay bales, conifer (pine) seedlings, or other materials that may cause minor skin breaks. It is also advisable to avoid skin contact with sphagnum moss. Moss has been implicated as a source of the fungus in a number of outbreaks.

References

CDC