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December 6, 1995

Handyperson's Hazard: Crawl Space Sporotrichosis

Author Affiliations

Fort Wayne, Ind
Medical College of Ohio Toledo

JAMA. 1995;274(21):1673-1674. doi:10.1001/jama.1995.03530210027018

To the Editor.  —Cutaneous sporotrichosis in the United States is associated with outdoor activities and typically follows traumatic injury with concurrent exposure to Sporothrix schenckii in sphagnum moss or thorny plants.1 We report three cases in which each patient contracted the disease while working in the same crawl space.The first was a 37-year-old man who, in December 1993, had been working in a crawl space under his house in Indiana. Three days later, he noticed "bumps" that, despite antibacterial therapies, developed within 10 weeks into an inflamed verrucous plaque on the wrist (Figure 1, for example) and into ulcerated lesions accompanied by multiple nodules along the lymphatics on his face. His 33-year-old wife, who had worked in the crawl space in January 1994, developed a lesion at the site of a recent cat scratch on her thumb. Five weeks later, this lesion ulcerated, and several erythematous nodules were

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