Sporotrichosis: Cutaneous Fungal Infection, Diagnosis, and Treatment with Itraconazole | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"La sporotrichose est une mycose sous-cutan\u00e9e caus\u00e9e par Sporothrix schenckii apr\u00e8s inoculation traumatique. 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<h1>Sporotrichosis<\/h1>\n<style>.oc-fiche-cta{margin:8px 0 34px;padding:22px 24px;border:1.5px solid rgba(50,60,82,.15);border-left:4px solid #FF611C;border-radius:12px;background:#F4F6F8;font-family:Poppins,sans-serif}.oc-fiche-cta-t{font-size:18px;font-weight:600;color:#323C52;margin:0 0 4px;line-height:1.35}.oc-fiche-cta-x{font-size:15px;color:#4D6577;margin:0 0 14px;line-height:1.55}.oc-fiche-cta-b{display:flex;flex-wrap:wrap;gap:10px}.oc-fiche-cta-b a{display:inline-flex;align-items:center;justify-content:center;min-height:44px;padding:10px 18px;border-radius:8px;font-size:14px;font-weight:600;text-decoration:none;box-sizing:border-box}.oc-fiche-cta-b .oc-p{background:#FF611C;color:#fff}.oc-fiche-cta-b .oc-p:hover{background:#E04E0C}.oc-fiche-cta-b .oc-s{background:#fff;color:#323C52;border:1.5px solid rgba(50,60,82,.25)}@media (max-width:600px){.co-wrap h1{font-size:24px;line-height:1.25;text-transform:none}.oc-fiche-cta{padding:18px 16px}.oc-fiche-cta-b a{flex:1 1 100%}body .co-wrap > .co-table,body .co-wrap > .co-table tbody,body .co-wrap > .co-table tr,body .co-wrap > .co-table td{display:block;width:100%;box-sizing:border-box}body .co-wrap > .co-table{min-width:0;table-layout:auto}body .co-wrap > .co-table thead{display:none}body .co-wrap > .co-table tr{margin:0 0 10px;border:1px solid rgba(77,101,119,.18);border-radius:8px;overflow:hidden}body .co-wrap > .co-table td{padding:9px 12px;border:0}body .co-wrap > .co-table td:first-child{font-weight:600;color:#323C52;background:rgba(77,101,119,.07)}#ocw{transform:scale(.8);transform-origin:bottom right}}<\/style><div class=\"oc-fiche-cta\" data-oc-cta=\"fiche-haut-consult\"><p class=\"oc-fiche-cta-t\">Obtenir un avis adapt\u00e9 \u00e0 votre situation<\/p><p class=\"oc-fiche-cta-x\">Consultation en clinique ou en t\u00e9l\u00e9consultation, partout au Qu\u00e9bec.<\/p><div class=\"oc-fiche-cta-b\"><a class=\"oc-p\" href=\"https:\/\/cliniqueomicron.ca\/rendez-vous\/\">Make an appointment<\/a><a class=\"oc-s\" href=\"https:\/\/cliniqueomicron.ca\/consultation-en-ligne\/\">Consult online<\/a><a class=\"oc-s\" href=\"tel:+15146063350\">514 606-3350<\/a><\/div><\/div>\n\n\n <div class=\"co-intro\">\n La sporotrichose est une mycose sous-cutan\u00e9e \u2014 infection fongique profonde des tissus cutan\u00e9s et sous-cutan\u00e9s \u2014 caus\u00e9e par le complexe <em>Sporothrix schenckii<\/em> (Dimorphic fungus: filamentous in the environment + yeast-like at 37\u00b0C in human tissues), present in soil + decaying vegetation + peat moss + rotten wood + rose thorns + straw + and ornamental plants. Contamination most often occurs by transcutaneous traumatic inoculation during a wound from a thorn + splinter + animal bite + or contact with contaminated soil \u2014 without the patient always remembering it clearly (the initial wound may be minimal). Sporotrichosis is nicknamed \u00abrose gardener's disease\u00bb or \u00abrose-thorn disease\u00bb in English, although it can affect farmers + horticulturists + miners + foresters + florists + and anyone working with plants or soil. The most common clinical form is cutaneous-lymphatic sporotrichosis \u2014 characterized by the appearance of a painless or slightly painful nodule at the inoculation site that progressively evolves into ulceration + followed by the emergence of secondary nodules in a chain along the ascending lymphatic pathway (lymphangitic sporotrichosis \u2014 quasi-pathognomonic) \u2014 the progression of which can be extremely slow (weeks to months) and the diagnosis of which is often delayed because it is confused with bacterial skin infections + cutaneous leishmaniasis + or mycobacteriosis. Disseminated sporotrichosis (bones + joints + lungs + meninges) is rare and occurs almost exclusively in severely immunocompromised individuals (HIV\/AIDS with very low CD4 counts + prolonged corticosteroid therapy + alcoholism + severe diabetes). Oral itraconazole is the reference treatment for cutaneous forms with excellent results.\n <\/div>\n\n <h2>Clinical forms<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Shape<\/th>\n <th>Frequency<\/th>\n <th>Clinical presentation<\/th>\n <th>Treatment<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Cutan\u00e9o-lymphatique (lymphangitique)<\/td>\n <td>70\u201375 % des cas + forme la plus fr\u00e9quente<\/td>\n <td>Nodule primaire indolore au site d'inoculation (main + avant-bras ++ + doigt) \u2192 ulc\u00e9ration centrale + cro\u00fbte + puis nodules secondaires multiples en chapelet ascendant le long du trajet lymphatique (cordon lymphangitique rosaire) \u2192 chaque nodule peut s'ulc\u00e9rer + fistuliser + exsuder<\/td>\n <td>Itraconazole 200 mg\/j \u00d7 3\u20136 mois<\/td>\n <\/tr>\n <tr>\n <td>Cutan\u00e9e fix\u00e9e (localis\u00e9e)<\/td>\n <td>20\u201325 % des cas<\/td>\n <td>L\u00e9sion unique ulc\u00e9r\u00e9e ou verruqueuse au site d'inoculation + SANS propagation lymphatique + fr\u00e9quente dans les zones d'end\u00e9mie o\u00f9 l'immunit\u00e9 est acquise + peut ressembler \u00e0 un carcinome \u00e9pidermo\u00efde + ou \u00e0 une leishmaniose cutan\u00e9e<\/td>\n <td>Itraconazole 200 mg\/j \u00d7 3\u20136 mois + ou thermoth\u00e9rapie locale (chaleur 40\u201342 \u00b0C) si itraconazole contre-indiqu\u00e9<\/td>\n <\/tr>\n <tr>\n <td>Pulmonary<\/td>\n <td>< 5 % \u2014 inhalation de conidies<\/td>\n <td>Toux + h\u00e9moptysie + cavitation pulmonaire (ressemble \u00e0 la tuberculose) + excavations apicales + immunod\u00e9prim\u00e9 + alcoolique + mineur de charbon ++ \u2192 risque de confusion avec tuberculose ou histoplasmose<\/td>\n <td>Itraconazole 200 mg \u00d7 2\/j \u00d7 12 mois + ou amphot\u00e9ricine B lipidique (formes s\u00e9v\u00e8res)<\/td>\n <\/tr>\n <tr>\n <td>Ost\u00e9o-articulaire<\/td>\n <td>< 5 % \u2014 diss\u00e9mination h\u00e9matog\u00e8ne<\/td>\n <td>Arthrite septique chronique (genou + poignet + cheville) + ost\u00e9omy\u00e9lite + immunod\u00e9prim\u00e9 + souvent confondu avec arthrite rhumato\u00efde ou septique bact\u00e9rienne<\/td>\n <td>Itraconazole 200 mg \u00d7 2\/j \u00d7 12 mois minimum + drainage chirurgical si n\u00e9cessaire<\/td>\n <\/tr>\n <tr>\n <td>Diss\u00e9min\u00e9e (SNC + multi-organes)<\/td>\n <td>Tr\u00e8s rare \u2014 VIH stade SIDA + CD4 tr\u00e8s bas<\/td>\n <td>M\u00e9ningite fongique + l\u00e9sions cutan\u00e9es diss\u00e9min\u00e9es + atteinte h\u00e9patique + spl\u00e9nique + pronostic sombre sans traitement rapide<\/td>\n <td>Amphot\u00e9ricine B lipidique (Ambisone\u00ae) 3\u20135 mg\/kg\/j IV \u2192 induction + relais itraconazole apr\u00e8s stabilisation + dur\u00e9e prolong\u00e9e<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Diagnosis<\/h2>\n <ul class=\"co-list\">\n <li><strong>Mycological culture (gold standard):<\/strong> Pus or material collection from the ulcerated lesion + skin biopsy \u2192 Sabouraud medium culture at 25\u201328 \u00b0C \u2192 white to cream filamentous colony \u2192 then culture at 37 \u00b0C \u2192 yeast-like conversion (dimorphism confirms the genus Sporothrix) \u2192 identification by MALDI-TOF or ITS sequencing + incubation time: 7 to 14 days \u2192 no growth on standard temperature media.< 25\u00b0C (essentially)<\/li>\n <li><strong>Histopathologie (biopsie cutan\u00e9e) :<\/strong> suppurative granuloma + giant cells + asteroid bodies (Splendore-Hoeppli phenomenon \u2014 hypersensitivity reaction around the fungus) + budding yeasts <em>Sporothrix<\/em> (few \u2192 NOT + Grocott-Gomori + Mayer-Mucicarmine) \u2192 direct yeast search is often negative (low fungal burden) \u2192 culture remains essential<\/li>\n <li><strong>Serology<\/strong> tests ELISA (IgG + IgM anti-<em>Sporothrix<\/em>) \u2192 useful for diagnosing disseminated or extradermal forms + sensitivity of 80\u201390% in disseminated forms + less useful in localized cutaneous forms<\/li>\n <li><strong>PCR :<\/strong> available in certain reference laboratories + rapid identification of the complex <em>Sporothrix schenckii<\/em> + useful if culture is negative or results are ambiguous<\/li>\n <\/ul>\n\n <h2>Diagnostic diff\u00e9rentiel \u2014 syndrome sporotricho\u00efde<\/h2>\n <ul class=\"co-list\">\n <li><strong>Syndrome sporotricho\u00efde :<\/strong> Several infectious agents can mimic lymphocutaneous sporotrichosis with ascending nodular lesions, and the presentation is so characteristic that it deserves its own name (sporotrichoid syndrome or nodular lymphangitis syndrome).<\/li>\n <li><strong>Mycobact\u00e9rium marinum :<\/strong> contact with water + aquariums + fish + lesions very similar to sporotrichosis \u2192 mycobacterial culture + PCR + no response to itraconazole \u2192 clarithromycin + ethambutol<\/li>\n <li><strong>Leishmaniose cutan\u00e9e :<\/strong> Travel to an endemic area + vector (sandfly) + smear + Leishmania culture + PCR<\/li>\n <li><strong>Nocardiose cutan\u00e9e :<\/strong> <em>Nocardia brasiliensis<\/em> Immunocompromised + Latin America + multiple fistulas + sulfur granules + bacteriological culture (slow-growing aerobic Nocardia)<\/td><\/li>\n <li><strong>Tular\u00e9mie cutan\u00e9e :<\/strong> Contact with hare, rabbit, rodent, hunting, inoculation ulcer, regional adenopathy, Francisella tularensis serology<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>La sporotrichose est la cause principale d'une l\u00e9sion cutan\u00e9e avec nodules en chapelet ascendant le long d'un trajet lymphatique (syndrome sporotricho\u00efde) mais plusieurs autres agents peuvent la mimer \u2014 <em>Mycobacterium marinum<\/em> (aquariums + fish) is the most frequent differential diagnosis in Canada. Always ask the patient about recent exposures: gardening + roses + thorns + aquariums + contact with animals + travel to tropical areas. Mycological culture on a specialized medium at two temperatures is essential to confirm the diagnosis.<\/span>\n <\/div>\n\n <h2>Treatment<\/h2>\n <ul class=\"co-list\">\n <li><strong>Itraconazole (traitement de r\u00e9f\u00e9rence \u2014 formes cutan\u00e9es) :<\/strong> 200 mg\/day orally \u00d7 3\u20136 months (cutaneous-lymphatic forms) + take with meals or an acidic beverage (absorption is improved in an acidic environment) + monitor for drug interactions (numerous interactions via CYP3A4 \u2014 statins + oral anticoagulants + antiarrhythmics) + efficacy: cure in 90\u201395% of cutaneous forms + monitoring of liver transaminases (rare hepatotoxicity)<\/li>\n <li><strong>Terbinafine 500 mg\/day:<\/strong> alternative to itraconazole + comparable efficacy in cutaneous-lymphatic forms (recent meta-analyses) + few drug interactions + good tolerability<\/li>\n <li><strong>Solution satur\u00e9e d'iodure de potassium (SSIK) :<\/strong> Historical treatment still used in low-resource countries + exact mechanism not well understood + effective but significant adverse effects (metallic taste + nausea + iododerma + hypothyroidism) + declining use in developed countries<\/li>\n <li><strong>Thermoth\u00e9rapie locale :<\/strong> local heat application (104\u2013107.6 \u00b0F \u00d7 30 min \u00d7 2\/day) \u2192 <em>Sporothrix<\/em> is thermosensitive \u2192 option in local forms if itraconazole is contraindicated (pregnancy + interactions) + or as a supplement to antifungal treatment<\/li>\n <li><strong>Formes diss\u00e9min\u00e9es s\u00e9v\u00e8res :<\/strong> Liposomal amphotericin B (Ambisome\u00ae) 3\u20135 mg\/kg\/day IV until clinical stabilization + then switch to itraconazole 200 mg BID \u00d7 12 months minimum<\/li>\n <li><strong>Pregnancy:<\/strong> Itraconazole contraindicated (teratogenic) \u2192 local thermotherapy for localized cutaneous forms + liposomal amphotericin B for severe forms + after childbirth \u2192 itraconazole<\/li>\n <\/ul>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin si un nodule cutan\u00e9 indolore appara\u00eet apr\u00e8s une blessure par une \u00e9pine + une \u00e9charde + ou un contact avec de la terre ou des v\u00e9g\u00e9taux + particuli\u00e8rement s'il \u00e9volue vers l'ulc\u00e9ration et si de nouveaux nodules apparaissent le long du bras ou de la jambe en remontant \u2014 ce tableau \u00e9voque une sporotrichose n\u00e9cessitant une biopsie cutan\u00e9e + une culture mycologique et un traitement antifongique. Pour le bilan d'une l\u00e9sion cutan\u00e9e chronique post-traumatique et la prescription de l'itraconazole, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron reconnaissent le tableau clinique de la sporotrichose (nodule d'inoculation + chapelet de nodules lymphatiques ascendants + contexte de jardinage ou de contact avec la v\u00e9g\u00e9tation), prescrivent la biopsie cutan\u00e9e + la culture mycologique \u00e0 deux temp\u00e9ratures, initient le traitement par itraconazole 200 mg\/jour pour les formes cutan\u00e9es, orientent vers l'infectiologie ou la dermatologie pour les formes atypiques ou r\u00e9fractaires, et g\u00e8rent les interactions m\u00e9dicamenteuses de l'itraconazole. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un infectiologue. La sporotrichose n\u00e9cessite une confirmation diagnostique par culture mycologique avant d'initier le traitement antifongique. L'itraconazole est contre-indiqu\u00e9 pendant la grossesse. La dur\u00e9e du traitement ne doit pas \u00eatre raccourcie m\u00eame si les l\u00e9sions semblent gu\u00e9ries \u2014 le risque de rechute est \u00e9lev\u00e9 si le traitement est arr\u00eat\u00e9 pr\u00e9matur\u00e9ment.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Sporotrichose : infection fongique cutan\u00e9e, diagnostic et traitement par itraconazole | Clinique Omicron Infectiologie & Dermatologie & M\u00e9decine de famille Sporotrichose La sporotrichose est une mycose sous-cutan\u00e9e \u2014 infection fongique profonde des tissus cutan\u00e9s et sous-cutan\u00e9s \u2014 caus\u00e9e par le complexe Sporothrix schenckii (champignon dimorphique : filamenteux dans l’environnement + levuriforme \u00e0 37\u00b0C dans les… <a href=\"https:\/\/cliniqueomicron.ca\/en\/sporotrichose\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Sporotrichosis: Cutaneous Fungal Infection, Diagnosis, and Treatment with Itraconazole | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Sporotrichose | Brossard | Clinique Omicron","_metasync_otto_description":"Sporotrichose Sporotrichose est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de la sant\u00e9 \u00e0 la...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Sporotrichose | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Sporotrichose Sporotrichose est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de la sant\u00e9 \u00e0 la...","_metasync_otto_twitter_title":"Sporotrichose | Clinique Omicron","_metasync_otto_twitter_description":"Sporotrichose Sporotrichose est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. 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<h1>Sporotrichosis<\/h1>\n<style>.oc-fiche-cta{margin:8px 0 34px;padding:22px 24px;border:1.5px solid rgba(50,60,82,.15);border-left:4px solid #FF611C;border-radius:12px;background:#F4F6F8;font-family:Poppins,sans-serif}.oc-fiche-cta-t{font-size:18px;font-weight:600;color:#323C52;margin:0 0 4px;line-height:1.35}.oc-fiche-cta-x{font-size:15px;color:#4D6577;margin:0 0 14px;line-height:1.55}.oc-fiche-cta-b{display:flex;flex-wrap:wrap;gap:10px}.oc-fiche-cta-b a{display:inline-flex;align-items:center;justify-content:center;min-height:44px;padding:10px 18px;border-radius:8px;font-size:14px;font-weight:600;text-decoration:none;box-sizing:border-box}.oc-fiche-cta-b .oc-p{background:#FF611C;color:#fff}.oc-fiche-cta-b .oc-p:hover{background:#E04E0C}.oc-fiche-cta-b .oc-s{background:#fff;color:#323C52;border:1.5px solid rgba(50,60,82,.25)}@media (max-width:600px){.co-wrap h1{font-size:24px;line-height:1.25;text-transform:none}.oc-fiche-cta{padding:18px 16px}.oc-fiche-cta-b a{flex:1 1 100%}body .co-wrap > .co-table,body .co-wrap > .co-table tbody,body .co-wrap > .co-table tr,body .co-wrap > .co-table td{display:block;width:100%;box-sizing:border-box}body .co-wrap > .co-table{min-width:0;table-layout:auto}body .co-wrap > .co-table thead{display:none}body .co-wrap > .co-table tr{margin:0 0 10px;border:1px solid rgba(77,101,119,.18);border-radius:8px;overflow:hidden}body .co-wrap > .co-table td{padding:9px 12px;border:0}body .co-wrap > .co-table td:first-child{font-weight:600;color:#323C52;background:rgba(77,101,119,.07)}#ocw{transform:scale(.8);transform-origin:bottom right}}<\/style><div class=\"oc-fiche-cta\" data-oc-cta=\"fiche-haut-consult\"><p class=\"oc-fiche-cta-t\">Obtenir un avis adapt\u00e9 \u00e0 votre situation<\/p><p class=\"oc-fiche-cta-x\">Consultation en clinique ou en t\u00e9l\u00e9consultation, partout au Qu\u00e9bec.<\/p><div class=\"oc-fiche-cta-b\"><a class=\"oc-p\" href=\"https:\/\/cliniqueomicron.ca\/rendez-vous\/\">Make an appointment<\/a><a class=\"oc-s\" href=\"https:\/\/cliniqueomicron.ca\/consultation-en-ligne\/\">Consult online<\/a><a class=\"oc-s\" href=\"tel:+15146063350\">514 606-3350<\/a><\/div><\/div>\n\n\n <div class=\"co-intro\">\n La sporotrichose est une mycose sous-cutan\u00e9e \u2014 infection fongique profonde des tissus cutan\u00e9s et sous-cutan\u00e9s \u2014 caus\u00e9e par le complexe <em>Sporothrix schenckii<\/em> (Dimorphic fungus: filamentous in the environment + yeast-like at 37\u00b0C in human tissues), present in soil + decaying vegetation + peat moss + rotten wood + rose thorns + straw + and ornamental plants. Contamination most often occurs by transcutaneous traumatic inoculation during a wound from a thorn + splinter + animal bite + or contact with contaminated soil \u2014 without the patient always remembering it clearly (the initial wound may be minimal). Sporotrichosis is nicknamed \u00abrose gardener's disease\u00bb or \u00abrose-thorn disease\u00bb in English, although it can affect farmers + horticulturists + miners + foresters + florists + and anyone working with plants or soil. The most common clinical form is cutaneous-lymphatic sporotrichosis \u2014 characterized by the appearance of a painless or slightly painful nodule at the inoculation site that progressively evolves into ulceration + followed by the emergence of secondary nodules in a chain along the ascending lymphatic pathway (lymphangitic sporotrichosis \u2014 quasi-pathognomonic) \u2014 the progression of which can be extremely slow (weeks to months) and the diagnosis of which is often delayed because it is confused with bacterial skin infections + cutaneous leishmaniasis + or mycobacteriosis. Disseminated sporotrichosis (bones + joints + lungs + meninges) is rare and occurs almost exclusively in severely immunocompromised individuals (HIV\/AIDS with very low CD4 counts + prolonged corticosteroid therapy + alcoholism + severe diabetes). Oral itraconazole is the reference treatment for cutaneous forms with excellent results.\n <\/div>\n\n <h2>Clinical forms<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Shape<\/th>\n <th>Frequency<\/th>\n <th>Clinical presentation<\/th>\n <th>Treatment<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Cutan\u00e9o-lymphatique (lymphangitique)<\/td>\n <td>70\u201375 % des cas + forme la plus fr\u00e9quente<\/td>\n <td>Nodule primaire indolore au site d'inoculation (main + avant-bras ++ + doigt) \u2192 ulc\u00e9ration centrale + cro\u00fbte + puis nodules secondaires multiples en chapelet ascendant le long du trajet lymphatique (cordon lymphangitique rosaire) \u2192 chaque nodule peut s'ulc\u00e9rer + fistuliser + exsuder<\/td>\n <td>Itraconazole 200 mg\/j \u00d7 3\u20136 mois<\/td>\n <\/tr>\n <tr>\n <td>Cutan\u00e9e fix\u00e9e (localis\u00e9e)<\/td>\n <td>20\u201325 % des cas<\/td>\n <td>L\u00e9sion unique ulc\u00e9r\u00e9e ou verruqueuse au site d'inoculation + SANS propagation lymphatique + fr\u00e9quente dans les zones d'end\u00e9mie o\u00f9 l'immunit\u00e9 est acquise + peut ressembler \u00e0 un carcinome \u00e9pidermo\u00efde + ou \u00e0 une leishmaniose cutan\u00e9e<\/td>\n <td>Itraconazole 200 mg\/j \u00d7 3\u20136 mois + ou thermoth\u00e9rapie locale (chaleur 40\u201342 \u00b0C) si itraconazole contre-indiqu\u00e9<\/td>\n <\/tr>\n <tr>\n <td>Pulmonary<\/td>\n <td>< 5 % \u2014 inhalation de conidies<\/td>\n <td>Toux + h\u00e9moptysie + cavitation pulmonaire (ressemble \u00e0 la tuberculose) + excavations apicales + immunod\u00e9prim\u00e9 + alcoolique + mineur de charbon ++ \u2192 risque de confusion avec tuberculose ou histoplasmose<\/td>\n <td>Itraconazole 200 mg \u00d7 2\/j \u00d7 12 mois + ou amphot\u00e9ricine B lipidique (formes s\u00e9v\u00e8res)<\/td>\n <\/tr>\n <tr>\n <td>Ost\u00e9o-articulaire<\/td>\n <td>< 5 % \u2014 diss\u00e9mination h\u00e9matog\u00e8ne<\/td>\n <td>Arthrite septique chronique (genou + poignet + cheville) + ost\u00e9omy\u00e9lite + immunod\u00e9prim\u00e9 + souvent confondu avec arthrite rhumato\u00efde ou septique bact\u00e9rienne<\/td>\n <td>Itraconazole 200 mg \u00d7 2\/j \u00d7 12 mois minimum + drainage chirurgical si n\u00e9cessaire<\/td>\n <\/tr>\n <tr>\n <td>Diss\u00e9min\u00e9e (SNC + multi-organes)<\/td>\n <td>Tr\u00e8s rare \u2014 VIH stade SIDA + CD4 tr\u00e8s bas<\/td>\n <td>M\u00e9ningite fongique + l\u00e9sions cutan\u00e9es diss\u00e9min\u00e9es + atteinte h\u00e9patique + spl\u00e9nique + pronostic sombre sans traitement rapide<\/td>\n <td>Amphot\u00e9ricine B lipidique (Ambisone\u00ae) 3\u20135 mg\/kg\/j IV \u2192 induction + relais itraconazole apr\u00e8s stabilisation + dur\u00e9e prolong\u00e9e<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <h2>Diagnosis<\/h2>\n <ul class=\"co-list\">\n <li><strong>Mycological culture (gold standard):<\/strong> Pus or material collection from the ulcerated lesion + skin biopsy \u2192 Sabouraud medium culture at 25\u201328 \u00b0C \u2192 white to cream filamentous colony \u2192 then culture at 37 \u00b0C \u2192 yeast-like conversion (dimorphism confirms the genus Sporothrix) \u2192 identification by MALDI-TOF or ITS sequencing + incubation time: 7 to 14 days \u2192 no growth on standard temperature media.< 25\u00b0C (essentially)<\/li>\n <li><strong>Histopathologie (biopsie cutan\u00e9e) :<\/strong> suppurative granuloma + giant cells + asteroid bodies (Splendore-Hoeppli phenomenon \u2014 hypersensitivity reaction around the fungus) + budding yeasts <em>Sporothrix<\/em> (few \u2192 NOT + Grocott-Gomori + Mayer-Mucicarmine) \u2192 direct yeast search is often negative (low fungal burden) \u2192 culture remains essential<\/li>\n <li><strong>Serology<\/strong> tests ELISA (IgG + IgM anti-<em>Sporothrix<\/em>) \u2192 useful for diagnosing disseminated or extradermal forms + sensitivity of 80\u201390% in disseminated forms + less useful in localized cutaneous forms<\/li>\n <li><strong>PCR :<\/strong> available in certain reference laboratories + rapid identification of the complex <em>Sporothrix schenckii<\/em> + useful if culture is negative or results are ambiguous<\/li>\n <\/ul>\n\n <h2>Diagnostic diff\u00e9rentiel \u2014 syndrome sporotricho\u00efde<\/h2>\n <ul class=\"co-list\">\n <li><strong>Syndrome sporotricho\u00efde :<\/strong> Several infectious agents can mimic lymphocutaneous sporotrichosis with ascending nodular lesions, and the presentation is so characteristic that it deserves its own name (sporotrichoid syndrome or nodular lymphangitis syndrome).<\/li>\n <li><strong>Mycobact\u00e9rium marinum :<\/strong> contact with water + aquariums + fish + lesions very similar to sporotrichosis \u2192 mycobacterial culture + PCR + no response to itraconazole \u2192 clarithromycin + ethambutol<\/li>\n <li><strong>Leishmaniose cutan\u00e9e :<\/strong> Travel to an endemic area + vector (sandfly) + smear + Leishmania culture + PCR<\/li>\n <li><strong>Nocardiose cutan\u00e9e :<\/strong> <em>Nocardia brasiliensis<\/em> Immunocompromised + Latin America + multiple fistulas + sulfur granules + bacteriological culture (slow-growing aerobic Nocardia)<\/td><\/li>\n <li><strong>Tular\u00e9mie cutan\u00e9e :<\/strong> Contact with hare, rabbit, rodent, hunting, inoculation ulcer, regional adenopathy, Francisella tularensis serology<\/li>\n <\/ul>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>La sporotrichose est la cause principale d'une l\u00e9sion cutan\u00e9e avec nodules en chapelet ascendant le long d'un trajet lymphatique (syndrome sporotricho\u00efde) mais plusieurs autres agents peuvent la mimer \u2014 <em>Mycobacterium marinum<\/em> (aquariums + fish) is the most frequent differential diagnosis in Canada. Always ask the patient about recent exposures: gardening + roses + thorns + aquariums + contact with animals + travel to tropical areas. Mycological culture on a specialized medium at two temperatures is essential to confirm the diagnosis.<\/span>\n <\/div>\n\n <h2>Treatment<\/h2>\n <ul class=\"co-list\">\n <li><strong>Itraconazole (traitement de r\u00e9f\u00e9rence \u2014 formes cutan\u00e9es) :<\/strong> 200 mg\/day orally \u00d7 3\u20136 months (cutaneous-lymphatic forms) + take with meals or an acidic beverage (absorption is improved in an acidic environment) + monitor for drug interactions (numerous interactions via CYP3A4 \u2014 statins + oral anticoagulants + antiarrhythmics) + efficacy: cure in 90\u201395% of cutaneous forms + monitoring of liver transaminases (rare hepatotoxicity)<\/li>\n <li><strong>Terbinafine 500 mg\/day:<\/strong> alternative to itraconazole + comparable efficacy in cutaneous-lymphatic forms (recent meta-analyses) + few drug interactions + good tolerability<\/li>\n <li><strong>Solution satur\u00e9e d'iodure de potassium (SSIK) :<\/strong> Historical treatment still used in low-resource countries + exact mechanism not well understood + effective but significant adverse effects (metallic taste + nausea + iododerma + hypothyroidism) + declining use in developed countries<\/li>\n <li><strong>Thermoth\u00e9rapie locale :<\/strong> local heat application (104\u2013107.6 \u00b0F \u00d7 30 min \u00d7 2\/day) \u2192 <em>Sporothrix<\/em> is thermosensitive \u2192 option in local forms if itraconazole is contraindicated (pregnancy + interactions) + or as a supplement to antifungal treatment<\/li>\n <li><strong>Formes diss\u00e9min\u00e9es s\u00e9v\u00e8res :<\/strong> Liposomal amphotericin B (Ambisome\u00ae) 3\u20135 mg\/kg\/day IV until clinical stabilization + then switch to itraconazole 200 mg BID \u00d7 12 months minimum<\/li>\n <li><strong>Pregnancy:<\/strong> Itraconazole contraindicated (teratogenic) \u2192 local thermotherapy for localized cutaneous forms + liposomal amphotericin B for severe forms + after childbirth \u2192 itraconazole<\/li>\n <\/ul>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin si un nodule cutan\u00e9 indolore appara\u00eet apr\u00e8s une blessure par une \u00e9pine + une \u00e9charde + ou un contact avec de la terre ou des v\u00e9g\u00e9taux + particuli\u00e8rement s'il \u00e9volue vers l'ulc\u00e9ration et si de nouveaux nodules apparaissent le long du bras ou de la jambe en remontant \u2014 ce tableau \u00e9voque une sporotrichose n\u00e9cessitant une biopsie cutan\u00e9e + une culture mycologique et un traitement antifongique. Pour le bilan d'une l\u00e9sion cutan\u00e9e chronique post-traumatique et la prescription de l'itraconazole, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron reconnaissent le tableau clinique de la sporotrichose (nodule d'inoculation + chapelet de nodules lymphatiques ascendants + contexte de jardinage ou de contact avec la v\u00e9g\u00e9tation), prescrivent la biopsie cutan\u00e9e + la culture mycologique \u00e0 deux temp\u00e9ratures, initient le traitement par itraconazole 200 mg\/jour pour les formes cutan\u00e9es, orientent vers l'infectiologie ou la dermatologie pour les formes atypiques ou r\u00e9fractaires, et g\u00e8rent les interactions m\u00e9dicamenteuses de l'itraconazole. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un infectiologue. La sporotrichose n\u00e9cessite une confirmation diagnostique par culture mycologique avant d'initier le traitement antifongique. L'itraconazole est contre-indiqu\u00e9 pendant la grossesse. La dur\u00e9e du traitement ne doit pas \u00eatre raccourcie m\u00eame si les l\u00e9sions semblent gu\u00e9ries \u2014 le risque de rechute est \u00e9lev\u00e9 si le traitement est arr\u00eat\u00e9 pr\u00e9matur\u00e9ment.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Sporotrichose : infection fongique cutan\u00e9e, diagnostic et traitement par itraconazole | Clinique Omicron Infectiologie & Dermatologie & M\u00e9decine de famille Sporotrichose La sporotrichose est une mycose sous-cutan\u00e9e \u2014 infection fongique profonde des tissus cutan\u00e9s et sous-cutan\u00e9s \u2014 caus\u00e9e par le complexe Sporothrix schenckii (champignon dimorphique : filamenteux dans l’environnement + levuriforme \u00e0 37\u00b0C dans les… <a href=\"https:\/\/cliniqueomicron.ca\/en\/sporotrichose\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Sporotrichosis: Cutaneous Fungal Infection, Diagnosis, and Treatment with Itraconazole | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Sporotrichose | Brossard | Clinique Omicron","_metasync_otto_description":"Sporotrichose Sporotrichose est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de la sant\u00e9 \u00e0 la...","_metasync_otto_keywords":"","_metasync_otto_og_title":"Sporotrichose | Clinique Omicron Qu\u00e9bec","_metasync_otto_og_description":"Sporotrichose Sporotrichose est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de la sant\u00e9 \u00e0 la...","_metasync_otto_twitter_title":"Sporotrichose | Clinique Omicron","_metasync_otto_twitter_description":"Sporotrichose Sporotrichose est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. Nos professionnels de la sant\u00e9 \u00e0 la...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Sporotrichose : infection fongique cutan\u00e9e, diagnostic et traitement par itraconazole | Clinique Omicron","_aioseo_description":"La sporotrichose est une mycose sous-cutan\u00e9e par Sporothrix schenckii apr\u00e8s inoculation traumatique \u00e9pine terre. Nodules en chapelet lymphatique ascendant maladie jardiniers roses, culture Sabouraud, itraconazole 200mg 3-6 mois au Qu\u00e9bec.","_metasync_seo_title":"Sporotrichose | Clinique Omicron","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_imported_seo_title":"","_metasync_imported_seo_desc":"","_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-09-03T07:54:38+00:00\"}","_metasync_robots_advanced":"","_metasync_og_title":"Sporotrichose | Clinique Omicron Qu\u00e9bec","_metasync_og_description":"Sporotrichose Sporotrichose est une condition m\u00e9dicale qui peut n\u00e9cessiter une \u00e9valuation et un suivi m\u00e9dical appropri\u00e9s. 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