When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Sporotrichosis

Last reviewed: 4 May 2025
Last updated: 10 May 2023

Summary

Definition

History and exam

Key diagnostic factors

  • primary skin lesion
  • nodular lymphangitis lesions
Full details

Other diagnostic factors

  • respiratory symptoms
  • joint swelling/erythema
  • male 30 to 60 years old
  • fever
  • lymphadenopathy
  • meningitis-like symptoms
Full details

Risk factors

  • trauma to the skin
  • outdoor occupation/hobbies
  • animal bites and scratches
  • alcohol use disorder
  • diabetes mellitus
  • HIV/AIDS
  • COPD
  • corticosteroid treatment
  • chemotherapy in patients with hematologic malignancy
  • hematopoietic stem cell/solid organ transplantation
  • tumor necrosis factor (TNF)-alpha inhibitor therapy
Full details

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • skin lesion fungal culture
  • skin lesion histopathology (Gomori methenamine silver, periodic acid-Schiff staining)
  • CBC
  • erythrocyte sedimentation rate
  • joint x-ray
  • fungal culture of arthrocentesis synovial fluid
  • sputum or bronchoalveolar lavage (BAL) fungal culture
  • lumbar puncture for cerebrospinal fluid analysis
  • cerebrospinal fluid (CSF) fungal culture
  • fungal blood culture
Detalhes completos

Investigações a serem consideradas

  • synovial tissue biopsy for fungal culture
  • synovial tissue histopathology (Gomori methenamine silver, periodic acid-Schiff staining)
  • bronchial biopsy fungal culture
  • bronchial biopsy histopathology
  • CXR
  • CT of chest
  • serum itraconazole levels
  • serum BUN
  • serum creatinine
  • LFTs
Detalhes completos

Novos exames

  • immunohistochemical staining
  • polymerase chain reaction (PCR)

Algoritmo de tratamento

AGUDA

nonpregnant: lymphocutaneous/cutaneous

nonpregnant: extracutaneous mild/moderate disease

nonpregnant: extracutaneous severe/life-threatening disease

pregnant: cutaneous

pregnant: lymphocutaneous

pregnant: extracutaneous

Colaboradores

Autores

Michail Lionakis, MD, ScD

Chief

Fungal Pathogenesis Section

Laboratory of Clinical Immunology and Microbiology

National Institutes of Allergy and Infectious Diseases

National Institutes of Health

Bethesda

MD

Declarações

ML declares that he has no competing interests.

John E. Bennett, MD

Chief

Clinical Mycology Section

Laboratory of Clinical Immunology and Microbiology

National Institute of Allergy and Infectious Diseases

National Institutes of Health

Bethesda

MD

Declarações

JEB declares that he has no competing interests.

Revisores

George Samonis, MD

Professor of Internal Medicine/Infectious Diseases

University of Crete

Department of Internal Medicine

Gallos University Campus

Crete

Greece

Declarações

GS declares that he has no competing interests.

​Amy Xu, MD, MA

Assistant Professor of Medicine

Section of Dermatology

University of Chicago

Chicago

IL

Declarações

AX declares that she has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Rex JH, Okhuysen PC. Sporothrix schenckii. In Bennett JE, Dolin R, Blaser MJ, eds. Principles and practice of infectious diseases. 9th ed. Philadelphia, PA: Elsevier, 2020: 3131-6.

Orofino-Costa R, Macedo PM, Rodrigues AM, et al. Sporotrichosis: an update on epidemiology, etiopathogenesis, laboratory and clinical therapeutics. An Bras Dermatol. 2017 Sep-Oct;92(5):606-20.Texto completo  Resumo

Kauffman CA, Bustamante B, Chapman SW, et al. Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007 Nov 15;45(10):1255-65.Texto completo  Resumo

Sharkey-Mathis PK, Kauffman CA, Graybill JR, et al. Treatment of sporotrichosis with itraconazole. NIAID Mycoses Study Group. Am J Med. 1993 Sep;95(3):279-85. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

O uso deste conteúdo está sujeito ao nosso aviso legal