Sporotrichosis (“Rose Gardener’s Disease”)
Sporotrichosis is a subcutaneous fungal infection caused by the dimorphic fungus Sporothrix schenckii. It is typically acquired via traumatic inoculation from contaminated plant material, such as rose thorns or sphagnum moss.
Clinical Presentation
- Initial Lesion: A small, painless papule or nodule at the site of inoculation.
- Lymphocutaneous Spread: Classically spreads along lymphatic channels, forming a “sporotrichoid” pattern of secondary nodules or ulcers proximal to the primary site.
- Progression: The lesions can ulcerate and become chronic if left untreated.
Diagnosis & Management
| Aspect | Details |
|---|---|
| Diagnosis | Fungal culture of biopsy tissue (gold standard). Histopathology may show cigar-shaped yeast cells. |
| Treatment | Itraconazole is the treatment of choice. Saturated solution of potassium iodide (SSKI) is a historical alternative. |
High-Yield Exam Pearl:
- Sporotrichoid Spread: If you see a patient with nodules appearing in a line along the arm, you must include Sporotrichosis, Mycobacterium marinum, and Nocardia in your differential diagnosis.
- Occupational History: Always ask about hobbies—landscaping, gardening, or working with hay/soil—when encountering suspicious subcutaneous nodules.