Systemic Sporotrichosis

Abstract

Four patients with systemic sporotrichosis are presented. All were adult men, and two were alcoholics. One patient had Hodgkin's disease, and another had multiple myeloma; both had widespread sporotrichotic infection, suggesting that development of multifocal systemic sporotrichosis is related to the role of Sporothrichum schenckii as an opportunistic invader. Characteristic cutaneous, pulmonary, and articular lesions occur in systemic sporotrichosis; erythrocyte sedimentation rates are elevated, and white blood cell counts are near normal. The prognosis is good in unifocal systemic sporotrichosis, but death may occur when the disease is multifocal. In both types of involvement intravenous amphotericin B is superior to iodide therapy. We emphasize that sporotrichosis should be considered a bona fide member of the systemic fungal diseases, that "opportunistic" infection occurs and may be responsible for an increasing frequency of disseminated systemic infection, and that diagnosis depends on the recognition of the characteristic cutaneous and joint involvement together with repeated multiple fungal cultures.