A 33-year-old Mexican fruit picker presents to a free clinic with subcutaneous nodular lesions along the lymphatics from the initial site of trauma 3 weeks ago caused by a plum thorn puncture. What is the nature of the most likely causative agent?

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Sporothrix schenckii, a dimorphic fungus, is found in the environment on various plant materials. Subcutaneous infections begin with traumatic implantation of contaminated plant material such as slivers from mine timbers, thorns, or the combination of wires and sphagnum moss (used by floral designers). The resulting sporotrichosis is characterized by a fixed nodular subcutaneous lesion or lesions along the lymphatics from the initial trauma site. When found in tissues, the fungus grows as an oval to cigar-shaped yeast. It grows as sporulating filaments in the environment and has a worldwide distribution. Cases are most common in tropical regions because people are less likely to wear protective clothing (e.g., long pants, long-sleeved shirts).

A 33-Year-Old Mexican Fruit Picker Presents to a Free Clinic