Sporotrichosis: Part II

Sporotrichosis is a subcutaneous mycosis of implantation. It is the only subcutaneous mycosis for which direct examination or histology is of little or no value for diagnosis. The diagnosis solely rests on the isolation of Sporothrix schenckii in culture. On pathologic examination, causative organisms are rarely seen. Staining with fluorescent-labeled antibodies may aid in visualizing the cigar-shaped yeast forms; however, the organisms are still difficult to identify. Topical therapy is not effective. Potassium iodide is an effective treatment for sporotrichosis, but this agent has not been subjected to specific treatment trials comparing its efficacy against azoles or allylamine alternatives. Itraconazole is generally safe and well tolerated, and the relapse rate is low. Terbinafine could be another therapeutic alternative to treat the disease. Since 1998, researchers from Brazil suggested that feline transmission of sporotrichosis in Rio de Janeiro city was associated with a large and long-lasting outbreak of the disease. To understand the outbreak, there have been studies on the epidemiology and antifungal susceptibility of the S schenckii strains through molecular diagnosis. Data suggest that all isolated strains were genetically related.