title: Sporotrichosis outbreak and mouldy  hay in NSW.
abstract: BACKGROUND
  Sporotrichosis is a subacute/chronic fungal infection caused by Sporothrix schenckii. The fungus thrives on organic matter including hay, wood, moss, soil and plants. Zoonotic transmission has also been reported. Lesions present as superficial skin nodules that become purulent and ulcerate. Lymphocutaneous spread is common. Haematogenous spread is uncommon and case fatality is rare.
  
  
  OBJECTIVE
  The aim of this article is to describe an outbreak of sporotrichosis in New South Wales.
  
  
  CONCLUSIONS
  A cluster of six cases was identified in the NSW mid-north coast area in the first half of 2013. Telephone interviews were conducted in an attempt to identify possible exposures. General practitioners were contacted to report on patients with chronic non-healing skin lesions. A batch of mouldy hay supplied by a local farmer was identified as the potential source of exposure. Despite effective treatment with oral antifungals, diagnosis of sporotrichosis is often delayed and prolonged courses of antibiotics are unnecessarily prescribed. Timely detection and management (including referral to a dermatologist or infectious diseases specialist) significantly reduces morbidity. Personal protection is the key to prevention.
authors.affiliation: MBBS, MD, MPH, Advanced Trainee Public Health Medicine, Population Health, Hunter New England Health, Wallsend, NSW.
authors.forename: Deeksha
authors.initials: D
authors.lastname: Dhingra
authors.forename: David
authors.initials: D
authors.lastname: Durrheim
authors.forename: Philippe
authors.initials: P
authors.lastname: Porigneaux
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D013175:Sporothrix / Q000302:isolation & purification*; D013174:Sporotrichosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents