Sporotrichosis

Sporotrichosis is a chronic fungal infection that most commonly involves the skin and lymphatics. It is classified into five forms: classic lymphocutaneous, fixed cutaneous, disseminated cutaneous, primary pulmonary, and systemic sporotrichosis. Its diagnosis is established by fungal culture or by direct immunofluorescence. Safe effective therapy for cutaneous sporotrichosis exists in the form of oral potassium iodide and local heat therapy. However, itraconazole, one of the newer triazole antimycotic agents, appears quite effective against Sporothrix schenckii and may provide a means of reducing both the length of therapy and the relapse rate. Systemic sporotrichosis, although still rare, is becoming more common, especially in immunosuppressed patients. Because of multisystem involvement, both diagnosis and management of patients with systemic sporotrichosis are difficult. Serologic antibody tests such as the slide latex agglutination test are useful to confirm the diagnosis and to determine the effectiveness of antifungal therapy. Intravenous amphotericin B is still considered the drug of choice for systemic sporotrichosis, but the search for a less toxic agent continues. Also, combination drug therapy and surgical intervention are necessary for some patients with extracutaneous sporotrichosis.