Case Of Lymphocutaneous Sporotrichosis Research Articles

Lymphocutaneous Sporotrichosis

Sporotrichosis is a chronic subcutaneous mycosis caused by a fungus, Sporothrix schenckii complex. The first case in India was reported by Ghosh in 1932. The disease is prevalent primarily in the sub-Himalayan region, North-eastern states, and parts of Karnataka. Mostly seen in adults, it uncommonly presents in children over the face and limbs either as fixed cutaneous or lymphocutaneous form. Here, we present a case of 3-years-old boy hailing from Southern Tamil Nadu with multiple nodular lesions in linear fashion over the right upper limb. It was diagnosed as a case of lymphocutaneous sporotrichosis that developed following cut injury over the right index finger. We publish this case as it is rare to occur in this geographic location.

Prospective analysis of perinatal outcome of pregnant women with asymptomatic bacteriuria

Objective: Isolated case reports describing the utility of Fine Needle Aspiration Cytology (FNAC) in the diagnosis of Lymphocutaneous sporotrichosis are available in the literature. Since Himachal Pradesh in India is a known endemic area for cutaneous sporotrichosis, this study was conducted to assess the utility of FNAC in the detection of fungal spores for the diagnosis of lymphocutaneous sporotrichosis. Methods: FNAC and biopsy were performed from the nodules and indurated ulcers of fifty clinically diagnosed cases of lymphocutaneous sporotrichosis. Smears were reviewed for cytomorphological findings and were correlated with the histopathological findings. Positive cases were further subjected to culture for confirmation. Results: In our study, the sensitivity and specificity of FNAC in diagnosing lymphocutaneous sporotrichosis were 35% and 100% respectively. The sensitivity and specificity of biopsy in diagnosing lymphocutaneous sporotrichosis were 10% and 100% respectively. All seven cases diagnosed on FNAC were confirmed on fungal culture. Conclusions: FNAC is an effective, useful and a minimally invasive procedure. FNAC is comparatively better than biopsy in detection of fungal spores in the diagnosis of lymphocutaneous sporotrichosis. With an experienced cytologist, it can be used routinely for the diagnosis for lymphocutaneous sporotrichosis.

A case of lymphocutaneous sporotrichosis caused by Sporothrix schenckii sensu stricto finally diagnosed by molecular identification based on "ITS" and "CAL" coding regions in combination with phenotypic analysis

A 54-year-old female farmer presented with a pea-sized red nodule on the left upper limb near the wrist for 15 days, which occurred after trauma, gradually became swollen and ruptured, and developed into multiple nodules arranged in a chain in 30 days. Skin examination revealed multiple hard purple-red nodules arranged in a line on her left upper limb, some of which were ruptured with a small amount of purulent exudate. Histopathological examination further revealed that the focus of infection manifested as pyogenic granuloma-like inflammation mainly infiltrated with mixed inflammatory cells. Periodic acid Schiff (PAS) staining showed no fungal structures, including fungal spores, hyphae and asteroid body. The biopsy tissue culture yielded the fungus. According to the morphological analysis of the cultures and results of molecular identification based on internal transcribed spacer (ITS) and calmodulin (CAL) coding regions, this case was finally diagnosed as lymphocutaneous sporotrichosis caused by Sporothrix schenckii sensu stricto. The patient was treated with oral potassium iodide 10% solution in a dose of 10 ml thrice a day. After 2-month treatment, the patient felt that the lesions were obviously improved, but afterwards she was lost to follow-up. This research report suggests that phenotypic analysis combined with ITS/CAL-based molecular identification can accurately identify Sporothrix schenckii complex at the species level. Key words: Sporotrichosis; Sporothrix; Phenotype; Sequence alignment; Sporothrix schenckii sensu stricto

Sporotrichosis in north‐east India

Reports on the occurrence of sporotrichosis in some parts of north-east India are scarce. We report here five cases of lymphocutaneous sporotrichosis from north-east India, including one from Sikkim State and four from distant places in the north-eastern part of West Bengal. All patients were full or part-time farmers or gardeners. Diagnosis of sporotrichosis was confirmed by isolation of Sporothrix schenckii in culture and in vitro conversion of the isolates to yeast form. The cases were treated with 50% solution of potassium iodide.

Successful treatment of cutaneous sporotrichosis with terbinafine

Three cases of lymphocutaneous sporotrichosis were successfully treated with oral terbinafine at a dose of 125 mg once daily rather than 250 mg twice daily as reported previously. The clinical response was rapid in two patients. The duration of treatment was 8, 10 and 29 weeks, respectively, for the three patients treated. No major side-effects were noted. There was no relapse on subsequent follow-up. Terbinafine at a dose of 125 mg once daily thus proved to be effective and safe in the treatment of lymphocutaneous sporotrichosis.

Sporotrichosis in Sudan

Two cases of lymphocutaneous sporotrichosis are reported from Sudan in a boy aged four and a half years and a girl aged 16 years respectively. Diagnosis was based mainly on the clinical findings and the dramatic response to treatment with oral potassium iodine, as well as the histological finding of yeasts compatible with the yeast phase Sporothrix schenkii.

Sporotrichosis in Children

Nine cases of lymphocutaneous sporotrichosis in children occurred in Kansas in the fall of 1969. All the children had played in stacks of baled prairie hay from which Sporotrichum schenckii was recovered. This outbreak is, to our knowledge, the largest reported outbreak of sporotrichosis in children and the first outbreak reported due to contaminated prairie hay. It is suggested that when adequately exposed to contaminated material children are as susceptible as adults.