Wednesday, September 21, 2016

A Florist Presents With Non Tender Nodule On Her Hand



A 40-year-old florist presents to your office complaining of a nontender nodule that formed on her hand, then enlarged, and finally ulcerated. In the days that followed, the patient developed similar nodules in the area of the axillary lymphatics. Otherwise she has had no other symptoms.
The most likely diagnosis is

A) Cat-scratch fever
B) Sporotrichosis
C) Tuberculosis
D) Blastomycosis
E) Histoplasmosis

Answer and Discussion
The answer is B. Sporotrichosis

Sporotrichosis is a disease caused by inoculation of the plant Sporothrix schenckii when patients prick themselves with a thorn. The condition is associated with the formation of nodules, ulcers, and abscesses affecting the skin and lymphatic system. Farm workers and those who work around plants (i.e., florists, gardeners, nursery workers, and horticulturists) such as sphagnum moss, rosebushes, and barberry bushes are the most likely to be affected.


Clinical Features: Most patients present with a nontender nodule that forms on an arm or hand. The nodule enlarges, becomes erythematous (blush red), and finally ulcerates. In the following days, other nodules may
form in the area of the draining lymphatics. Local pain and constitutional symptoms are usually absent. Other areas such as lungs, spleen, liver, kidney, genitalia, muscle, joints, and eyes may become involved.

Diagnosis is usually achieved by culturing the organism from the nodules.

Treatment is accomplished with itraconazole and extended courses of saturated solution of potassium iodide; in severe disseminated cases, intravenous amphotericin B or ketoconazole (less effective) is used.

2 comments:

  1. Nice blog
    Have been totally convinced that HIV,and many others dangerous diseases can be best cured using the Herbal Medicine. Dr.Akpu the great and powerful herbalist cured me with his Herbal remedy. I'm Linda,15 years from Texas. I was born with HIV. I lost parents at my teenager age when I was 4th. I had to grew up with my mum only Sister, whom I loved so much. She was so worried about my life as my condition was her mature problem in life. I had taken lots of antiviral treatment to get ride of the virus not believing what there said HIV has no cure. I was on the internet when i came across blogs of testimony about a lady who where cured of a 7 years diagnose of Herpes by this powerful Herbalist, Dr.Akpu.I wrote down his mail @ Dr.akpupowerherbscenter@gmail.com
    I told my Aunt,luckily it was the same Dr,we where referred to few months back by my pastor in church whom members have being testifying about of his cure We did contacted him and explained my problem to him.He prepared the medicine and sent to me with details of how to use and apply. After a while, I began to feel more strong than never before, I felt so lucky and happy when my Doctor congratulated me that he could found no HIV virus again in me. I knew I was free cos my body was so strong. His herbal medicine should have saved my parents life, i said!
    Thanks so much for reading my article, you should share your testimony if you have cure as well
    Dr.akpupowerherbscenter@gmail.com
    Is the solution

    ReplyDelete
  2. Nice blog
    Have been totally convinced that HIV,and many others dangerous diseases can be best cured using the Herbal Medicine. Dr.Akpu the great and powerful herbalist cured me with his Herbal remedy. I'm Linda,15 years from Texas. I was born with HIV. I lost parents at my teenager age when I was 4th. I had to grew up with my mum only Sister, whom I loved so much. She was so worried about my life as my condition was her mature problem in life. I had taken lots of antiviral treatment to get ride of the virus not believing what there said HIV has no cure. I was on the internet when i came across blogs of testimony about a lady who where cured of a 7 years diagnose of Herpes by this powerful Herbalist, Dr.Akpu.I wrote down his mail @ Dr.akpupowerherbscenter@gmail.com
    I told my Aunt,luckily it was the same Dr,we where referred to few months back by my pastor in church whom members have being testifying about of his cure We did contacted him and explained my problem to him.He prepared the medicine and sent to me with details of how to use and apply. After a while, I began to feel more strong than never before, I felt so lucky and happy when my Doctor congratulated me that he could found no HIV virus again in me. I knew I was free cos my body was so strong. His herbal medicine should have saved my parents life, i said!
    Thanks so much for reading my article, you should share your testimony if you have cure as well
    Dr.akpupowerherbscenter@gmail.com
    Is the solution

    ReplyDelete