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Epidemiology
The dimorphic fungus Sporothrix schenckii is found worldwide. The environmental niches for the organism include sphagnum moss, decaying vegetation, hay, and soil. Infection is seen most often in persons whose vocation or avocation brings them into contact with the environment. Landscaping, rose gardening, Christmas tree farming, topiary production, baling hay, and motor vehicle accidents have all been associated with sporotrichosis.56,57 Less commonly, pulmonary sporotrichosis results from inhalation of S. schenckii conidia from soil. Cases of sporotrichosis usually occur sporadically, but outbreaks have been described. The largest outbreak in the United States involved 84 patients in 25 states and was traced back to conifer seedlings that had been packed in sphagnum moss from Wisconsin.56
S. schenckii can also be acquired through exposure to animals that are either infected or are able to passively transfer the organism from soil through scratching or biting. A variety of animals have been reported to transmit sporotrichosis, but cats with ulcerated skin lesions appear to be the most infectious. Clusters of sporotrichosis involving families and veterinarians caring for infected cats have been described.58,59