Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Sporotrichosis is a cutaneous (skin) infection caused by a fungus, Sporothrix schenckii. This infection-causing fungus is related more closely to the mold on stale bread or the yeast used to brew beer than to bacteria that usually cause infections. The fungus is found on rose thorns, hay, sphagnum moss, twigs, and soil. Therefore, the infection is more common among gardeners who work with roses, moss, hay, and soil. Occasionally, other animals such as dogs or horses may become infected.
The disease has often been termed as "rose handler's disease" in older publications because people growing roses had a high incidence of the disease. This was due to the fact that the fungi present on rose thorns and in the moss and soil used to cultivate roses easily contaminated the small pricks and cuts on the skin made by the rose thorns.
Peru, Brazil, U.S., China, and West Australia are the countries where most infections occur. In the U.S., there are about 200-250 documented infections per year.
Most cases of sporotrichosis only involve the skin and/or subcutaneous tissues and are non-life-threatening, but the infection requires treatment with prescription antifungal medication for several months. The most common treatment for this type of sporotrichosis is oral itraconazole for 3 to 6 months. Itraconazole may also be used to treat bone and joint infections, but treatment should continue for at least 12 months.
For patients with severe disease, and/ or an infection that has spread throughout the body, a lipid formulation of amphotericin B should be used. Itraconazole can be used for step-down therapy once the patient has stabilized. Supersaturated potassium iodide (SSKI) is another treatment option for cutaneous or lymphocutaneous disease. SSKI and azole drugs like itraconazole should not be used during pregnancy. Treatment recommendations may differ for children.