Extracutaneous sporotrichosis.

Area of Science:

• Medical Mycology
• Infectious Diseases

Background:

• Sporothrix schenckii commonly presents as cutaneous sporotrichosis.
• This fungal infection typically manifests as superficial nodules along lymphatic pathways.

Observation:

• A review of 58 sporotrichosis cases at Mayo Clinic (1937-present) identified 11 with extracutaneous involvement.
• Extracutaneous sites included joints (knee, wrist), mandible, and ethmoid sinuses.
• Three patients experienced disseminated systemic infection, with one fatality.

Findings:

• Seven patients had significant joint infections.
• Five patients were on systemic corticosteroids prior to diagnosis.
• Treatments involved supersaturated potassium iodide, amphotericin B, and 2-hydroxystilbamidine isethionate.

Implications:

• Sporotrichosis, while often cutaneous, poses a risk for disseminated, life-threatening infections.
• Early recognition and treatment of extracutaneous forms are crucial.
• Immunocompromised status, including corticosteroid use, may predispose to severe disease.