Sporotrichosis in a Nutshell

Classical presentation of sporotrichosis contain the following findings: Patient who is a gardener/landscaper, or who recently was exposed to decaying plant matter/soil Acute development of a single papule that ulcerates  Odorless, non-purulent drainage  Subsequent ulcerating papules proximal to the first on the affected extremity No systemic symptoms  With this classical picture, the pathogen in question is the dimorphic fungus  Sporotrix schenckii , which causes its namesake condition, sporotrichosis . Diagnosis requires aspiration or culture. Treatment is 3 - 6 months of itraconazole . 

The Utility of DLCO

DLCO  (" D iffusing capacity of the L ungs for  CO "), also known as " transfer factor of the lungs for CO", is a key metric in the evaluation of pulmonary diseases, and is often involved in the work-up of respiratory symptoms like dyspnea. Part of spirometry testing, its key purpose is to evaluate the function of gas exchange across the alveolar-capillary membrane, using CO as the proxy molecule standing in for other respiratory gases like oxygen. CO is a gas that diffuses across the alveolar-capillary membrane and binds with high affinity to hemoglobin. This high affinity makes CO diffusion more independent of cardiac output and metabolic rate than oxygen.  One useful application of DLCO is its use in differentiating the types of restrictive and obstructive lung diseases . Since DLCO reflects the properties of the alveolar-capillary membrane, a decrease in the rate of CO diffusion would indicate a change in the gas-exchanging portions of the lung parenchyma. A no