Clinical And Laboratory Study On A Case Of Cutaneous Lymphatic Sporotrichosis Caused By Sporothrix Globosa

A case of cutaneous lymphatic sporotrichosis caused by Sporothrix globosa and related clinical and laboratory studies were reported.A 48-yearold male vegetable farmers presented with rashes on the back of his right hand and forearm without pain or itching for more than one month.Dermatological examination revealed multiple linear red papules,nodules and ulcers arranged in a line on his right dorsum of hand and forearm.Both direct microscopic examination and Gram staining of pus fungi were negative.Histopathological examination showed Infective granuloma.Sporothrix globosa was identified by tube culture,slide culture and molecular biological identification.Scanning electron microscopy showed that conidia grew on or at the top of conidia pedicel and grew in isolation and upright position;conidia produced in synaxes,and whole wall spores produced transverse septum at the base,leaving dentate protuberances after shedding.The patient was treated with itraconazole combined with terbinafine orally and ruiconazole cream topically.The lesions were obviously improved after 2-month treatment.Sporotrichosis is a chronic infectious disease involving the skin,subcutaneous tissue,mucosa and local lymphatic system,and even systemic dissemination by Sporotrichosis complex.Patients with cutaneous sporotrichosis had a history of trauma before onset.Lymphatic sporotrichosis is the most common type of cutaneous.Typical manifestations are nodules,ulcers at the inoculation site and along the lymphatic centripetal line.The disease can be diagnosed according to clinical manifestations and laboratory examinations and fungal culture is the gold standard.Microstructure of bacteria was observed by scanning electron microscopy.Molecular biology technology can provide a new method for accurate and rapid identification of strains.At present,the treatment of sporotrichosis is mainly drug therapy,including itraconazole,terbinafine,potassium iodide and amphotericin B,among which itraconazole is the first choice for the treatment of cutaneous sporotrichosis.Drug combination therapy has synergistic antimicrobial effect and is suitable for those with poor effect of single drug treatment.