sporotrichosis

Question 1

cutaneous dx present as

Answer 1

palisading granulomatous dermatitis surrounding a stellate suppurative abscess.

prganisms appear as cigar shaped yeast.

Question 2

immuno

Answer 2

biopsy and culture

Question 3

tx

Answer 3

itraconazole for cutaneous and lymphocutaneous sporotrichosis at a dose of 200 mg/day for 2-4 weeks.
resolve usually 3-6 months.

if no response, dose may be doubled or terbinafine 500 mg 2x a day.

cutaneous form- potassium iodide 3-6g/day remain an effective and inexpensive tx option -‘d may be effectice when itraconazole tx fails.
iodide tx usually req 6-12wks of tx.
dose should be inc 40-50 drops 3x a day.

potassium iodide not for pregnant women!

adjuct - hot compress, hot packa or heating pad twice a day. S.schenckii is intolerant to temperatures above 38.5 C (101F)

Question 4

tx- adults disseminated sporotrichosis

Answer 4

amphotericin B given as lipid formulation at 3-5mg/kg/day ff by itraconazole 200mg twice a day for atleast 1 year.

immunocompormised pxs- tx w 200mg/day lofelong.