Jerry was glad when a family friend offered him a summer job working at a nursery. The college junior, an agronomy major, handled large orders of plants and treatments like mulch. He often delivered to area farms. Just as he was getting ready to go back to school, Jerry developed sores on his hands that a doctor diagnosed as sporotrichosis.
This condition is a skin infection caused by the fungus Sporothrix schenckii, according to MedlinePlus. Doctors consider the ailment a potential occupational hazard for individuals who handle thorny plants, mulch, soil or baled hay.
Outbreaks have occurred among nursery workers, children playing on hay bales and greenhouse workers working with bayberry thorns, the Centers for Disease Control and Prevention (CDC) reports. In some cases, a widespread sporotrichosis infection occurs when individuals who have compromised immune systems inhale dust carrying the spores of the fungus.
Although infectious, this disorder is not contagious.
The first thing Jerry noticed at the end of the summer was a bump that looked like an insect bite on a finger on his right hand. Sporotrichosis bumps are typically small and painless. Each is red, pink or purple and appears where there was a break in the skin on a finger, hand or arm.
These bumps can appear up to three months after a cut, puncture or crack in the skin that was exposed to the spores of the sporotrichosis fungus. However, most occur within three weeks after exposure. Some workers experience punctures from wires or pine needles. As additional bumps or nodules appear, at least some will look like boils.
An individual with a sporotrichosis infection eventually develops skin ulcerations that resemble open sores. One potential complication is contracting secondary skin infections like strep or staph.
A sporotrichosis infection tends to follow the body’s lymphatic channels. This causes small sores that form lines on the skin as the infection moves up the individual’s arm or leg. In most cases, these sores remain unhealed and periodically drain unless the infected individual gets treatment.
Some individuals who inhale the fungus develop a pulmonary or disseminated infection. Although pneumonia seldom results, the patient experiences symptoms such as coughing, fever and shortness of breath.
A sporotrichosis infection can spread to other parts of the body such as the bones, joints and central nervous system when the individual exposed has a weakened immune system. Other possible complications in immunosuppressed individuals include arthritis, meningitis and reactions to medication used to treat the infection.
Diagnosis and Treatment
Doctors are able to make a diagnosis of sporotrichosis after a laboratory confirms the presence of the fungus from a swab or a biopsy of a skin nodule. The standard treatment for an infection that affects the skin or lymphatic system is an antifungal medication known as itraconazole. In some cases, doctors also prescribe it for infections in bones or joints. If the infection doesn’t respond to this drug, an alternative medication is potassium iodide (SSKI).
However, unusually severe cases or those with pulmonary involvement, an infection of the central nervous system or a disseminated infection, are initially treated with amphotericin B followed by itraconazole.
Infected individuals take itraconazole orally for up to a month after all skin lesions have disappeared. Some patients require the drug for as long as six months. Those with systemic disease sometimes need to continue treatment for up to 12 months.
Pregnant women must steer clear of drugs like SSKI and itraconazole. Doctors might also use different respective regimens for children and adults.
The best prevention against contracting a sporotrichosis infection is to wear protective clothing even when working in the family garden. This includes clothing with long sleeves plus gloves when handling any materials that can cause skin breaks for the fungus to enter. One of the most frequent culprits in these infections is sphagnum moss.