Pediatric Sporotrichosis Follow-up

Updated: Feb 12, 2019
  • Author: William P Baugh, MD; Chief Editor: Russell W Steele, MD  more...
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Follow-up

Further Outpatient Care

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  • The primary therapeutic approach to managing cutaneous lesions of sporotrichosis involves administration of systemic medications to eradicate the fungus. If a cutaneous plaque, nodule, or ulcer is present, consider teaching the patient about supportive local wound care to facilitate healing. Such education typically involves instruction on keeping lesions clean and free from further contamination. If the lesion is ulcerated, a topical ointment may be applied to prevent occurrence of secondary bacterial infections. Follow up with the patient in the clinic every 1-2 weeks to monitor progress. Instruct the patient about potential sources of this fungus to help avoid further infections.

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Further Inpatient Care

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  • Sporotrichosis is usually managed on an outpatient basis. A few patients with the more severe forms (eg, disseminated sporotrichosis) may require hospitalization.

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Inpatient & Outpatient Medications

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  • See Medical Care.

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Deterrence/Prevention

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  • Educate every patient who has acquired sporotrichosis about the fungus and provide information about how to prevent occurrence of further infections. S schenckii is a saprophytic fungus, usually found in the soil. Instruct patients to be careful when working with soils, sphagnum moss, decaying wood, roses, thorn bushes, and salt marsh or prairie hay. If exposure to these materials or plants is anticipated, instruct patients to wear personal protective equipment, particularly gloves, to minimize thorn or splinter punctures of the skin.

  • Sporotrichosis has also been acquired from pets, particularly cats, so the physician should consider this potential source of acquisition if the aforementioned soil and plant exposures do not apply.

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Prognosis

Prognosis for patients with sporotrichosis depends on its clinical type (eg, fixed cutaneous, localized cutaneous, lymphocutaneous, disseminated), associated underlying diseases, and the patient's immune response to this fungus.

  • Patients with fixed cutaneous and lymphocutaneous sporotrichosis have an excellent prognosis. These lesions usually respond well to therapy and typically resolve after 4-6 weeks of therapy.

  • Patients with the osteoarticular form of sporotrichosis usually have a moderately good prognosis, but they may require higher doses of medication, longer courses of therapy to achieve cure, or both.

  • Patients with pulmonary or disseminated forms of sporotrichosis usually have some underlying medical condition or immune deficit that allows the fungus to grow and spread unchecked. For example, patients who have insulin-dependent diabetes mellitus, chronic alcoholism, or AIDS may be unable to mount an adequate immune response to keep this fungal infection localized. Such patients typically have a worse prognosis and require longer courses of therapy.

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Patient Education

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  • See Deterrence/Prevention.

  • For excellent patient education resources, visit eMedicineHealth's Infections Center. Also, see eMedicineHealth's patient education article Sporotrichosis.

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