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Sporothrix schenckii

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Sporothrix schenckii

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Sporothrix schenckii

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USMLE® Step 1 style questions USMLE

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A 29-year-old man comes to the office for evaluation of a rash on his right upper extremity. The rash first appeared as a solid raised lesion on the right hand. Over the course of two days, it has grown and ulcerated. He reports serous fluid drainage from the ulceration. Two similar lesions appeared near the original lesion today. He does not report dyspnea, fever, chills, cough, or malaise. The patient recently started working at a farm. Vitals are within normal limits. Physical examination shows several indurated, mildly tender erythematous nodules on the right hand and forearm with central shallow ulceration. There is no lymphadenopathy. Which of the following best describes the characteristics of the infectious organism causing this presentation?  

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Summary

Sporothrix schenckii is a fungus that can be found in soil as well as in living and decomposing plant material such as peat moss. It is known to cause a skin infection known as sporotrichosis, which is also called rose gardener's disease.

Sporotrichosis typically begins as a small bump or nodule at the site of the skin injury and can then spread to nearby lymph nodes, causing them to become swollen and tender. Over time, the infection can progress and form a chain of nodules along the lymphatic vessels, creating a pattern that is sometimes referred to as "sporotrichoid spread." Sporotrichosis can be more severe in individuals with weakened immune systems, and in rare cases, it can affect the lungs, the bones, and the brain.

Sporotrichosis is diagnosed through history, physical exam, and a culture of the infected tissue or discharge. Treatment may involve antifungal medications, such as itraconazole, and in some cases, surgical removal of the infected tissue may be necessary.