A gardener presents with a subcutaneous lesion on the hand, which he thinks resulted from a wound he received while he was making a sphagnum moss-wire frame for a floral wreath. The nodule has ulcerated and not healed despite use of antibacterial cream and a new nodule is forming above original lesion. What is most likely to be an appropriate treatment for this infection?

Correct Answer: Oral itraconazole or potassium iodide
Description: This is a classic case of lymphocutaneous sporotrichosis in which a gardener or florist is infected a puncture wound. The drug of choice is either itraconazole or potassium iodide (administered orally in milk). Topical antifungals are not effective, and the coisone cream would probably enhance the spread of the disease.
Category: Microbiology
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