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Sporotrichosis — SCE Infectious Diseases MCQ

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ModerateFungal InfectionsSporotrichosisSCE Infectious Diseases

A 50-year-old man presents with a 2-month history of non-healing painless nodular lesions on his right forearm, tracking along the lymphatic channels from the wrist to the elbow (sporotrichoid pattern). He is an avid gardener. A tissue biopsy grows a dimorphic fungus after 10 days at 25°C. What is the most likely diagnosis and treatment?

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Correct answer: E — Sporotrichosis; Itraconazole 200 mg daily for 3–6 months

Sporotrichoid (lymphangitic) spread of nodular lesions in a gardener with a dimorphic fungus growing at 25°C is classic for Sporothrix schenckii. The organism exists as a mould at environmental temperatures and yeast at body temperature. Fixed cutaneous and lymphocutaneous sporotrichosis is treated with Itraconazole 200 mg daily for 3–6 months. Disseminated or pulmonary disease requires Liposomal Amphotericin B induction.

Reference: IDSA 2007 – Sporotrichosis guidelines; BSAC 2022 – Antifungal guidelines