Sporotrichosis is a relatively rare human disease, affecting mainly the skin and subcutaneous tissue, in rare cases, spreading to the mucous membrane of the upper respiratory tract.
Etiology of sporotrichosis.
The disease is caused by a fungus of the Sporotrichum family. The causative agent has many varieties. Sporotrihon vegetates on grasses, bushes, and trees. It can be found on cereals, in flour and street dust, on food products and animal wool. Infection occurs when the fungus gets on the damaged skin or mucous membrane or it enters the body with food, water, and inhaled dust. In the first case, there is a localized form of sporotrichosis, in the second - a disseminated form of the disease.
Pathological anatomy and pathogenesis of sporotrichosis.
When the pathogen is introduced into the damaged area of the skin or mucous membrane, a primary affect (sporotrichozal chancre) is formed at the site of implantation, leading to lymphangitis and new foci. Upon ingestion into the digestive tract and respiratory tract, the fungus, spreading by the hematogenous pathway, causes various forms of generalized gummous sporotrichosis of the upper respiratory tract. In the soft palate, epiglottis, aryepiglottic and vestigial folds, the disease manifests itself as infiltrates containing the same elements as the infiltrate in the defeat of the skin.
Symptoms of sporotrichosis
Symptoms and clinical course of sporotrichosis of the larynx differ little from other fungal diseases, except for actinomycosis. Patients complain of burning in the throat and larynx, the sensation of a foreign body, the phenomenon of dysphagia, and sometimes difficulty breathing. Under unfavorable external and internal conditions (humid hot climate, reinfection, the decrease in body resistance, etc.), the disease can progress, spreading along the extension to the trachea and bronchi or hematogenously - everywhere. The course of sporotrichosis is chronic, requiring long-term and systematic treatment.
Diagnosis of sporotrichosis
The diagnosis of sporotrichosis, if it proceeds in isolation, is very difficult and can be reliably established only with a histological examination of a biopsy specimen taken from a spirotrichotic infiltrate. Bacteriographic studies are ineffective since in pus it is rare to detect fungal elements. To confirm the diagnosis, the fungus culture is isolated and allergic skin and subcutaneous reactions with the fungal culture filtrate are carried out, as well as the spore agglutination reaction with the patient's blood serum.
Forecast. With early diagnosis, the prognosis is favorable even with disseminated form; It is much more serious if the mucous membranes, internal organs or bones are involved in the process.
Treatment of sporotrichosis
For the treatment of sporotrichosis, repeated courses of antifungal agents (itraconazole, irunine, fluconazole, fluminone, fungolone) are prescribed, combining them with sulfadimezin, 50% solution of potassium iodide in drops. With sporotrichosis of the larynx, local symptomatic treatment is used, aimed at reducing unpleasant subjective sensations. The cure depends on the effectiveness of the overall treatment.
Prevention consists of the careful and timely treatment of damaged skin in agricultural work, in flour milling, in the use of respirators.