Sporotrichosis in Ireland.

INTRODUCTION SPOROTRICHOSIS is a chronic fungal infection that is usually confined to the dermis and subcutaneous tissue, presenting typically with one or more ulcerating, gumma-like granulomas. Its cause is Sporothrix schenckii, a mould that has its natural habitat in decaying vegetation, straw, soil and the like, and occasionally on living plants, such as barbery (Berberis) and gorse (Ulex). The sporothrix enters the tissues through superficial wounds, such as abrasions, or when the skin is penetrated by contaminated spines or thorns of plants. In some cases the initial lesion is followed by ascending ulcerative lymphangiitis (Fig. 1); lymphadenitis seldom results, even in these cases. Disseminated haematogenous ('septicaemic') sporotrichosis and visceral sporotrichosis are fortunately very rare the mortality of these forms of the infection is very high. Cutaneous sporotrichosis, with or without lymphangiitis, may run a long course but seldom, if ever, puts the patient's life in any danger. Confirmation of the diagnosis is most regularly and reliably obtained by culturing the causative fungus from the lesions, a procedure that is usually straightforward, provided there is no bacterial contamination. Unlike virtually all other deep-seated fungal infections, sporotrichosis can seldom be diagnosed by histological examination: this is because the sporothrix is rarely demonstrable in infected human tissue (Symmers, 1964). The disease is of worldwide occurrence. It is seen frequently in some lands and very rarely in others. The number of cases in an area may vary remarkably from