Key points
- Sporotrichosis is an infection caused by the fungus Sporothrix.
- It typically causes severe skin infections but can affect other parts of the body.
- People can get sporotrichosis through scrapes in the skin (i.e., from thorns or cat scratches).
- In South America, a type of the fungus, Sporothrix brasiliensis (S. brasiliensis), is spreading between cats and people.
Overview
Sporotrichosis ("rose gardener's disease") is an infection caused by the fungus, Sporothrix. It can affect people and animals.
Sporothrix lives in soil and on plants, like sphagnum moss, rose bushes, and hay. People can get infected if Sporothrix gets in cuts or scrapes, such as pricks from rose thorns.
Usually, sporotrichosis causes severe skin infections. Less commonly, it can cause eye or lung infections. Very rarely, the infection can spread to other parts of the body. Sporothrix schenckii (S. schenckii) is the most common species of Sporothrix in the United States. Rarely, this strain can spread from animals to humans.
In South America, a type of sporotrichosis caused by S. brasiliensis is spreading easily between cats and people. Infections with S. brasiliensis tend to be more severe than infections with other Sporothrix species. There has not been any reported spread of S. brasiliensis in the United States to date, but cat-associated sporotrichosis is a growing global public health concern.
For Health Care Providers
Symptoms
The symptoms of sporotrichosis depend on how and where the fungus gets into the body. The most common type of infection is through the skin. Symptoms start anytime from 1 to 12 weeks after exposure.
Types of infection and symptoms include:
- Cutaneous (skin) - starts as a small painless red, purple, or pink bump on the skin. Over time, more bumps may start to appear, grow larger with pus or become open sores, and spread up the arm or from the infection site.
- Ocular (eye) - redness of the eye, redness or swelling of the eyelid, eye pain, and possible vision changes.
- Pulmonary (lung) - cough, shortness of breath, chest pain, and fever.
Disseminated sporotrichosis occurs when the infection spreads to another part of the body, such as the bones, joints, or central nervous system. This form of sporotrichosis usually affects people who have health conditions or take medicines that weaken their immune systems.
Sporotrichosis is not the same thing as cat-scratch disease, which is a bacterial illness spread by cats.
More Information on Cat-associated Sporotrichosis
For Health Care Providers: Cat-associated Sporotrichosis in Humans
For Veterinarians: Emerging Transmissible Sporotrichosis in Cats
Risk factors
Contact with plant matter increases risk for infection. This includes activities and occupations that involve gardening, forestry work, and baling hay.
In areas where cat-transmitted sporotrichosis is spreading, veterinarians and people who own or are around cats are most at risk. People can get sporotrichosis from infected cats even if the cat does not scratch or bite them. For example, people can get eye infections from touching their eyes after touching an infected cat.
Risk for severe infections
Severe forms of sporotrichosis (infections in lungs or disseminated infections) usually affect people with weakened immune systems or other diseases including diabetes, chronic obstructive pulmonary disease (COPD), alcohol use disorder, or HIV.
Prevention
To help prevent getting sporotrichosis:
- Wear protective clothing such as gloves and long sleeves when touching plant matter that can cause minor cuts or scrapes.
- Avoid contact with cats with sores or wounds.
In areas where sporotrichosis is common, cat owners should:
- Limit interactions between domestic and feral cats.
- Bring cats with sores or signs of sporotrichosis to a veterinarian right away.
- Inform the veterinarian of their cat's travel history, even if the cat shows signs of sporotrichosis years after the travel.
Testing and diagnosis
To test for sporotrichosis, a healthcare provider may:
- Take a swab or scrape from a skin sore and examine it under a microscope.
- Take a small tissue sample (biopsy) of the infected area of the body for laboratory tests.
- Test for lung or eye infections by collecting fluid or discharge from lung or eyes.
Blood tests may help diagnose severe sporotrichosis, but usually can't diagnose skin infections.
Treatment and recovery
Treatment depends on the type of infection.
- Skin sporotrichosis – several months of oral antifungal medication, like itraconazole or medications like supersaturated potassium iodide (SSKI).
- Lung or disseminated sporotrichosis – at least a year of antifungal medication, including intravenous amphotericin B medicine and oral itraconazole.
- People with sporotrichosis in the lungs may also need surgery to cut away the infected tissue.
- People with sporotrichosis in the lungs may also need surgery to cut away the infected tissue.
More fungal disease resources
Communication and Educational Materials
Webinars, Podcasts, and Clinical Tools
Resources and tools
Sporotrichosis: Training for national and district-level health workers- World Health Organization
Clinical Practice Guidelines for the Management of Sporotrichosis - Infectious Diseases Society of America