obsolete disseminated sporotrichosis

Definition and Characteristics

Obsolete disseminated sporotrichosis, also known as primary systemic mycosis, is a rare variant of sporotrichosis that results in systemic fungal infection through hematogenous spread [2]. This condition has its material basis in Sporothrix schenckii, a type of fungus that causes the infection.

Key Features

• A primary systemic mycosis that results in systemic fungal infection
• Caused by Sporothrix schenckii
• Characterized by systemic fungal infection through hematogenous spread

Note: The term "obsolete" suggests that this condition is no longer commonly used or recognized, and may be considered outdated. However, the definition and characteristics of this condition are still relevant for historical or medical reference purposes.

Citations: [2] Definition of obsolete disseminated sporotrichosis [3] Material basis in Sporothrix schenckii

Common Signs and Symptoms

Disseminated sporotrichosis, a rare form of sporotrichosis infection, can manifest in various ways. According to medical literature, the following are common signs and symptoms:

• Cutaneous lesions: Multiple skin lesions at non-contiguous sites without extracutaneous involvement [8]. These lesions can be ulcerated nodules with framed borders or crusted, verrucous, erythematous plaques [1].
• Localized lymphocutaneous form: This is the most common form of sporotrichosis, accounting for up to 95% of cases. It typically follows minor cutaneous trauma and presents as localized skin lesions with lymph node involvement [2].
• Fixed-cutaneous form: A less common form of spor

Diagnostic Tests for Disseminated Sporotrichosis

Disseminated sporotrichosis, a rare and severe form of the disease, requires prompt and accurate diagnosis to initiate effective treatment. While modern diagnostic techniques have improved, some older methods are still relevant in certain contexts.

• Intradermal reaction test with sporotrichin: This is considered one of the fastest methods for diagnosing sporotrichosis [1]. However, its accuracy may be limited by factors such as the presence of other skin conditions or the patient's immune response.
• Skin biopsy: A skin biopsy can provide a definitive diagnosis by demonstrating the presence of Sporothrix schenckii in tissue samples. This method is particularly useful when combined with histopathological examination [3].
• Fungal culture: Fungal culture from clinical specimens, such as pus or blood, can also confirm the diagnosis of disseminated sporotrichosis [5]. However, this method may take longer to yield results compared to other diagnostic tests.
• Blood culture: Blood culture is recommended if the disseminated form of the disease is suspected, particularly in cases where systemic manifestations are present [7].
• Cytologic examination: Cytologic examination of skin lesions can provide a presumptive diagnosis of disseminated sporotrichosis, although this method may not be as accurate as other diagnostic tests [6].

Less Common Diagnostic Tests

While less commonly used today, some older diagnostic tests for disseminated sporotrichosis include:

• Puncture of abscesses: Puncture of abscesses using a needle can provide a sample for fungal culture or histopathological examination [9].
• Nasal swabs and bronchoalveolar lavage samples: In rare cases, S. schenckii has been cultured from nasal swabs and bronchoalveolar lavage samples in patients with disseminated sporotrichosis [10].

It is essential to note that the diagnosis of disseminated sporotrichosis should be made by a qualified healthcare professional using a combination of clinical evaluation, laboratory tests, and imaging studies.

Treatment Options for Disseminated Sporotrichosis

Disseminated sporotrichosis, a rare and severe form of the fungal infection sporotrichosis, requires prompt and effective treatment to prevent serious complications. While there are several treatment options available, some have been considered obsolete due to their limited efficacy or potential side effects.

Potassium Iodide: An Obsolete Treatment Option

Historically, potassium iodide was one of the first drugs used to treat sporotrichosis, including its disseminated form [9]. However, with the advent of more effective and safer antifungal medications, potassium iodide has largely been replaced as a treatment option for this condition.

Itraconazole: A Preferred Treatment Option

Itraconazole, an azole antifungal medication, is currently considered the drug of choice for treating sporotrichosis, including its disseminated form [4][5]. It has proven to be effective in treating this condition with low toxicity and good tolerance. Itraconazole is typically administered orally at a dose of 100-200 mg/day for 3-6 months.

Other Treatment Options

While itraconazole is the preferred treatment option, other antifungal medications such as amphotericin B and fluconazole may also be used to treat disseminated sporotrichosis in certain cases [7][10]. However, these medications are generally reserved for patients who are resistant or intolerant to itraconazole.

Therapeutic Options

In addition to antifungal medications, therapeutic options such as thermotherapy (heat therapy) may also be used in combination with antifungal medications to treat disseminated sporotrichosis [3]. This approach has been shown to be effective in treating cutaneous-disseminated cases of this condition.

References:

[1] Romero-Cabello R, et al. (2011). Sporotrichosis. In: Clinical Mycology (pp. 123-135).

[2] Zhuang K, et al. (2022). Potassium iodide and itraconazole in combination with thermotherapy for the treatment of cutaneous-disseminated sporotrichosis.

[3] Zhuang K, et al. (2022). Combination therapy with potassium iodide and itraconazole for the treatment of disseminated sporotrichosis.

[4] Mahajan VK, et al. (2015). Itraconazole in the treatment of sporotrichosis: a review.

[5] Stalkup JR, et al. (2019). Itraconazole as maintenance therapy for disseminated sporotrichosis in patients with acquired immunodeficiency syndrome.

[6] Queiroz-Telles F, et al. (2019). Antifungal therapy and discontinuation of immunosuppressive therapy in patients with sporotrichosis.

[7] Garcia BM, et al. (2021). Disseminated-cutaneous sporotrichosis treated with oral itraconazole.

[8] Orofino-Costa R, et al. (2022). Potassium iodide as a therapeutic option for sporotrichosis.

Note: The references provided are based on the search results and may not be an exhaustive list of all relevant studies or publications on this topic.

Differential Diagnosis of Disseminated Sporotrichosis

Disseminated sporotrichosis, a rare variant of the fungal disease sporotrichosis, presents with multiple skin lesions at noncontiguous sites without extracutaneous involvement. The differential diagnosis for this condition includes:

• Atypical mycobacteria: These bacteria can cause similar symptoms to sporotrichosis, including skin lesions and systemic infection [4].
• Nocardiosis: This bacterial infection can also present with skin lesions and is a consideration in the differential diagnosis of disseminated sporotrichosis [4].
• Blastomycosis: A fungal disease that can cause skin lesions and is a potential differential for sporotrichosis, particularly in immunocompromised individuals [4].
• Pyogenic bacteria: Certain types of bacterial infections, such as those caused by Staphylococcus aureus or Streptococcus pyogenes, can present with skin lesions similar to sporotrichosis [4].
• Leishmaniasis: This parasitic infection can cause skin lesions and is a consideration in the differential diagnosis of disseminated sporotrichosis, particularly in endemic regions [3].

It's essential to consider these potential differentials when diagnosing disseminated sporotrichosis, as they may require distinct treatment approaches.

References:

• [1] BM Garcia (2021) - Initially considered a broad differential diagnosis for nodular dermatitis.
• [4] T Mollet (2015) - The differential diagnosis for sporotrichosis includes atypical mycobacteria, nocardiosis, blastomycosis, pyogenic bacteria, leishmaniasis, ...
• [3] R Romero-Cabello (2011) - Differential diagnosis with other pathologies includes leishmaniasis, chromoblastomycosis, tuberculosis verrucose and lymphangitis.