What is sporotrichosis. How is it caused. What are the symptoms of this fungal infection. When should you seek medical care for sporotrichosis. How is sporotrichosis diagnosed and treated. What is the outlook for people with sporotrichosis.

What is Sporotrichosis and How Does It Occur?

Sporotrichosis is a fungal infection of the skin caused by Sporothrix schenckii. This fungus is more closely related to mold and yeast than to bacteria. It’s commonly found in the environment, particularly on rose thorns, hay, sphagnum moss, twigs, and soil. The infection typically affects gardeners, nursery workers, and farmers who frequently come into contact with these materials.

How does sporotrichosis develop? The infection usually begins when fungal spores enter the skin through small cuts or punctures, often caused by rose thorns or sharp sticks. Interestingly, the infection can also occur through apparently unbroken skin after contact with contaminated hay or moss. In rare cases, cats or armadillos can transmit the disease. It’s important to note that sporotrichosis does not appear to spread from person to person.

Rare Forms of Sporotrichosis

While skin infection is the most common form of sporotrichosis, there are rare instances where the fungus can be inhaled or ingested. This can lead to infection in other parts of the body beyond the skin. These cases are particularly concerning and require specialized medical attention.

Recognizing the Symptoms of Sporotrichosis

What are the telltale signs of sporotrichosis? The initial symptom is typically a firm bump (nodule) on the skin, which can range in color from pink to nearly purple. This nodule is usually painless or only mildly tender. As the infection progresses, the nodule may develop into an open sore (ulcer) that drains clear fluid. Without treatment, these lesions can become chronic, persisting for years without significant change.

In about 60% of cases, the fungus spreads along the lymph nodes. This results in new nodules and ulcers appearing in a line up the infected arm or leg. These lesions can also persist for extended periods if left untreated.

Severe Cases of Sporotrichosis

In rare instances, particularly in individuals with weakened immune systems, sporotrichosis can spread to other parts of the body. This can affect the bones, joints, lungs, and even the brain. These severe cases are more challenging to treat and can potentially be life-threatening.

When to Seek Medical Care for Sporotrichosis

When should you consult a doctor about potential sporotrichosis? If you suspect you might have contracted this fungal infection, it’s crucial to seek medical attention promptly for proper diagnosis and treatment. Additionally, if you’re already undergoing treatment for sporotrichosis, contact your healthcare provider if new sores develop or if existing ones appear to be growing.

Is sporotrichosis ever an emergency? While skin and lymph node infections are generally not life-threatening, complications can arise. If you notice a rapidly expanding area of redness, pain, and warmth around the original ulcers, it’s advisable to seek immediate medical care at your local emergency room. This could indicate a secondary bacterial infection called cellulitis, which requires prompt treatment.

Diagnosing Sporotrichosis: Exams and Tests

How do doctors diagnose sporotrichosis? Since other infections can mimic its symptoms, healthcare professionals perform specific tests to confirm the diagnosis. The primary method involves a biopsy of one of the nodules, followed by microscopic examination of the sample to identify the fungus.

What other conditions might be mistaken for sporotrichosis? Differential diagnosis is crucial, as several other conditions can present similar symptoms:

• Bacteria related to tuberculosis or leprosy
• Cowpox
• Herpes infections
• Other fungal and bacterial infections
• Non-infectious diseases such as lupus

Treatment Options for Sporotrichosis

How is sporotrichosis treated? The approach to treatment varies depending on the site of infection and its severity. Let’s explore the different treatment options for various forms of sporotrichosis:

Skin Infections

For infections limited to the skin, traditional treatment involves a supersaturated potassium iodide solution. This medication is typically administered three times daily for three to six months until all lesions have resolved. Alternatively, skin infections may be treated with itraconazole (Sporanox) for up to six months.

An interesting adjunct therapy is heat application. Using a pocket warmer for one to two hours daily can create higher tissue temperatures, inhibiting fungal growth and allowing the immune system to combat the infection more effectively.

Bone and Joint Infections

Sporotrichosis affecting bones and joints is more challenging to treat. These infections rarely respond to potassium iodide. Instead, itraconazole is often used as the initial medication, with treatment lasting several months to a year. In some cases, amphotericin B may be necessary, administered intravenously. However, this drug has more side effects and may require prolonged administration. In severe cases, surgical removal of infected bone might be necessary.

Lung Infections

How are pulmonary sporotrichosis cases managed? Treatment for lung infections typically involves a combination of amphotericin B, itraconazole, and potassium iodide. The success of this regimen can vary. In some instances, surgical removal of infected lung tissue may be required.

Brain Infections

Sporotrichosis meningitis is a rare but severe form of the infection. Due to its rarity, treatment information is limited. Generally, a combination of amphotericin B and 5-fluorocytosine is recommended, with itraconazole as a potential alternative.

Follow-up Care and Monitoring for Sporotrichosis

What does follow-up care for sporotrichosis involve? Multiple follow-up visits with a healthcare provider are typically necessary to ensure the infection is resolving. During these appointments, your doctor will assess the progress of treatment and make any necessary adjustments. Once the disease has fully resolved, further follow-up care is generally not required.

Preventing Sporotrichosis: Key Strategies

How can you protect yourself from contracting sporotrichosis? The most crucial step in prevention is taking proper precautions when handling materials that may harbor the Sporothrix schenckii fungus. Here are some essential preventive measures:

1. Wear protective clothing, including long sleeves and gloves, when working with plants, soil, or moss.
2. Clean and disinfect any cuts or scrapes immediately after potential exposure.
3. Avoid handling stray cats or wild animals, particularly in areas where sporotrichosis is known to occur.
4. Maintain good hygiene practices, especially when working in gardens or agricultural settings.
5. Store hay and moss in dry, well-ventilated areas to prevent fungal growth.

Outlook for Individuals with Sporotrichosis

What is the prognosis for people diagnosed with sporotrichosis? Generally, the outlook for individuals with this fungal infection is positive, especially when the condition is diagnosed and treated promptly. Skin infections, which are the most common form, typically respond well to treatment and resolve without long-term complications.

However, the prognosis can vary depending on several factors:

• The extent and location of the infection
• The timeliness of diagnosis and treatment initiation
• The overall health and immune status of the individual
• Compliance with prescribed treatment regimens

For most patients with cutaneous sporotrichosis, complete resolution of symptoms can be expected within several months of starting treatment. However, it’s crucial to follow the full course of medication as prescribed by your healthcare provider, even if symptoms improve before the treatment is completed.

Challenges in Severe Cases

In rare cases where sporotrichosis spreads beyond the skin to organs like the lungs, bones, or brain, the outlook can be more guarded. These disseminated infections are more challenging to treat and may require prolonged therapy. In such cases, close monitoring and potentially more aggressive treatment approaches are necessary.

Despite these challenges, advances in antifungal medications and treatment strategies have significantly improved outcomes for even the most severe cases of sporotrichosis. Early detection and appropriate management remain key to achieving the best possible results.

Ongoing Research and Future Prospects in Sporotrichosis Management

What developments are on the horizon for sporotrichosis treatment and prevention? Ongoing research in the field of medical mycology continues to enhance our understanding of Sporothrix schenckii and its interactions with the human immune system. This knowledge is paving the way for potential new treatment strategies and preventive measures.

Emerging Treatment Approaches

Scientists are exploring several promising avenues for improving sporotrichosis treatment:

• Novel antifungal agents with enhanced efficacy and fewer side effects
• Immunotherapy approaches to boost the body’s natural defenses against the fungus
• Targeted drug delivery systems to improve treatment efficacy in disseminated infections
• Combination therapies that may shorten treatment duration and reduce the risk of drug resistance

Advancements in Diagnostic Techniques

Improved diagnostic methods are also under development, aiming to enable faster and more accurate identification of sporotrichosis infections. These include:

• Molecular diagnostic techniques for rapid fungal identification
• Advanced imaging methods to detect and monitor deep-tissue infections
• Serological tests for early detection of systemic sporotrichosis

These advancements hold the promise of earlier diagnosis and more tailored treatment approaches, potentially improving outcomes for patients with all forms of sporotrichosis.

Living with Sporotrichosis: Coping Strategies and Support

How can individuals diagnosed with sporotrichosis best manage their condition and maintain their quality of life? While sporotrichosis is generally treatable, living with the infection can present challenges, particularly for those with more severe or chronic cases. Here are some strategies to help cope with the condition:

Adherence to Treatment

Strict adherence to prescribed treatment regimens is crucial for successful management of sporotrichosis. This may involve:

• Taking medications as directed, even if symptoms improve
• Attending all follow-up appointments with healthcare providers
• Monitoring for any changes in symptoms and reporting them promptly

Wound Care and Hygiene

Proper care of skin lesions is essential to prevent secondary infections and promote healing:

• Keep affected areas clean and dry
• Use appropriate dressings as recommended by your healthcare provider
• Avoid scratching or irritating the affected areas

Lifestyle Modifications

Depending on the severity and location of the infection, some lifestyle adjustments may be necessary:

• Avoiding activities that may expose open lesions to further contamination
• Modifying work practices if the infection was occupationally acquired
• Maintaining overall health through proper nutrition and rest to support the immune system

Emotional Support

The psychological impact of living with a chronic infection should not be underestimated. Seeking emotional support can be beneficial:

• Joining support groups for individuals with fungal infections
• Consulting with a mental health professional if needed
• Educating family and friends about the condition to foster understanding and support

By implementing these coping strategies and working closely with healthcare providers, individuals with sporotrichosis can effectively manage their condition and maintain a good quality of life. As research continues to advance our understanding of this fungal infection, the outlook for those affected by sporotrichosis continues to improve, offering hope for even better management and outcomes in the future.

Sporotrichosis Basics

Written by WebMD Editorial Contributors

• Sporotrichosis Overview
• Causes of Sporotrichosis
• Symptoms of Sporotrichosis
• When to Seek Medical Care for Sporotrichosis
• Exams and Tests for Sporotrichosis
• Sporotrichosis Care at Home
• Medical Treatment for Sporotrichosis
• Follow-up Care for Sporotrichosis
• Sporotrichosis Prevention
• Outlook for Sporotrichosis
• More

Sporotrichosis is an infection of the skin caused by a fungus, Sporothrix schenckii. This fungus is related more closely to the mold on stale bread or the yeast used to brew beer than to bacteria that usually cause infections. The mold is found on rose thorns, hay, sphagnum moss, twigs, and soil. The infection is more common among gardeners, nursery workers, and farmers who work with roses, moss, hay, and soil.

Once the mold spores move into the skin, the disease takes days or even months to develop.

Sporotrichosis usually begins when mold spores are forced under the skin by a rose thorn or sharp stick, although the infection can begin in apparently unbroken skin after contact with hay or moss carrying the mold.

More rarely, cats or armadillos can transmit the disease.

In rare cases, the fungus can be inhaled or ingested, causing infection in parts of the body other than the skin.

Sporotrichosis does not appear to be transmitted from person to person.

The first symptom of sporotrichosis is a firm bump (nodule) on the skin that can range in color from pink to nearly purple. The nodule is usually painless or only mildly tender. Over time, the nodule may develop an open sore (ulcer) that may drain clear fluid. Untreated, the nodule and the ulcer become chronic and may remain unchanged for years.

In about 60% of cases, the mold spreads along the lymph nodes. Over time, new nodules and ulcers spread in a line up the infected arm or leg. These can also last for years.

In very rare cases, the infection can spread to other parts of the body, such as the bones, joints, lungs, and brain. This is more common among those with a weakened immune system. It can be difficult to treat and may be life threatening.

When to call the doctor

• If you think you might have sporotrichosis, see a doctor about diagnosis and treatment.
• If you are already being treated for sporotrichosis, contact a doctor if new sores develop or if the old ones appear to be growing.

When to go to the hospital

• Sporotrichosis in the skin or lymph nodes should not be dangerous or life threatening.
• Open ulcers can become infected with bacteria and may cause a condition known as cellulitis.
• If a rapidly expanding area of redness, pain, and warmth around the original ulcers develops, you should go to your local emergency room.

Other infections can mimic sporotrichosis, so a doctor performs tests to confirm the diagnosis. The tests for sporotrichosis usually involve a biopsy of one of the nodules, followed by an exam of the biopsy sample under a microscope to identify the mold. Other possible infections might include:

• Bacteria related to tuberculosis or leprosy
• Cowpox
• Herpes
• Other fungi and bacteria
• Noninfectious diseases such as lupus

No effective home care for sporotrichosis is known. Ulcers should be kept clean and covered until they are healed.

Treatment of sporotrichosis depends on the site infected.

• Infections in the skin only: These sporotrichosis infections have traditionally been treated with a supersaturated potassium iodide solution. This medicine is given three times per day for three to six months until all the lesions have gone away. Skin infections may also be treated with itraconazole (Sporanox) for up to six months. Also, heat therapy (pocket warmer for one- two hours daily) creates higher tissue temperature to inhibit fungus growth, allowing the immune system to fight the fungus.
• Sporotrichosis infection in the bones and joints: These infections are much more difficult to treat and rarely respond to potassium iodide. Itraconazole (Sporanox) is often used as an initial medication for several months or even up to a year. Amphotericin is also used, but this drug can only be given through an IV. Amphotericin has more side effects and may need to be administered for many months. Surgery is sometimes needed to remove infected bone.
• Infection in the lungs: Lung infections are treated with amphotericin,itraconazole (Sporanox), and potassium iodide with varying amounts of success. Sometimes, the infected areas of the lung have to be removed.
• Infection in the brain: Sporotrichosis meningitis is rare, so information on treatment is not readily available. Amphotericin plus 5-fluorocytosine is generally recommended, but itraconazole (Sporanox) might also be tried.

Multiple follow-up visits may be needed with a doctor to make sure sporotrichosis is disappearing. Once the disease goes away, further follow-up care is generally not needed.

The most important step in preventing sporotrichosis is preventing mold spores from entering the skin.

People who work with roses, hay, or sphagnum moss should cover any scratches or breaks in their skin. They should also wear heavy boots and gloves to prevent puncture wounds.

Most people who have sporotrichosis only in their skin or lymph nodes make a full recovery.

Treating a sporotrichosis infection may take several months or years, and scars may remain at the site of the original infection.

Infections involving the brain, lungs, joints, or other areas of the body are much more difficult to treat.

Top Picks

A Risk for Bacterial and Fungal Infection

The beautiful rose flower tops a green stem that has sharp outgrowths. Many people refer to these as thorns.

If you’re a botanist, you might call these sharp outgrowths prickles, as they’re part of the outer layer of the plant’s stem. They don’t meet the strict definition of thorns, which have deeper roots in a plant’s stem.

No matter what you call them, rose thorns are sharp enough to penetrate your skin and have the ability to pass infectious material into the wound, such as:

• dirt
• fertilizer
• bacteria
• fungi
• garden chemicals

These substances delivered into the skin by a thorn could result in a number of diseases, including:

• sporotrichosis
• plant-thorn synovitis
• mycetoma

Read on to learn the symptoms to watch for and how to treat infections from rose thorns.

Also known as rose gardener’s disease, rose picker’s disease is the common name of sporotrichosis.

Sporotrichosis is a relatively rare infection caused by the fungus Sporothrix. It occurs when the fungus gets into the skin via a small cut, scrape, or puncture, such as from a rose thorn.

The most common form, cutaneous sporotrichosis, is often found on the hand and arm of someone who has been handling contaminated plant materials.

The symptoms of cutaneous sporotrichosis usually start to appear between 1 and 12 weeks after infection. The progression of symptoms is typically the following:

1. A small and painless pink, red, or purple bump forms where the fungus entered the skin.
2. The bump get bigger and starts to look like an open sore.
3. More bumps or sores might appear in the near vicinity of the original bump.

Treatment

It’s likely your doctor will prescribe a several-month course of antifungal medication, such as itraconazole.

If you have a severe form of sporotrichosis, you doctor might start your treatment with an intravenous dose of amphotericin B followed by an antifungal medication for at least a year.

Plant-thorn synovitis is a rare cause of arthritis from a plant thorn penetrating a joint. This penetration causes inflammation of the synovial membrane. That’s the connective tissue that lines a joint.

Although Blackthorn or date palm thorns cause most reported cases of plant-thorn synovitis, the thorns of numerous other plants can cause it too.

The knee is the most common joint affected, but it can also affect the hands, wrists, and ankles.

Treatment

Currently, the only cure for plant-thorn synovitis is the removal of the thorn through surgery known as synovectomy. In this surgery, the connective tissue of the joint is removed.

Mycetoma is a disease caused by fungi and bacteria found in water and soil.

Mycetoma occurs when these specific fungi or bacteria repeatedly enter the skin through a puncture, scrape, or cut.

The fungal form of the disease is called eumycetoma. The bacterial form of the disease is called actinomycetoma.

Although rare in the United States, it often develops in people who live in rural areas of Latin America, Africa, and Asia that are near the equator.

The symptoms of both eumycetoma and actinomycetoma are similar. The disease starts with a firm, painless bump under the skin.

Over time the mass grows larger and develops oozing sores, making the affected limb unusable. It can spread from the initially infected area to other parts of the body.

Treatment

Antibiotics can often effectively treat actinomycetoma.

Although eumycetoma is commonly treated with long-term antifungal medication, treatment may not cure the disease.

Surgery, including amputation, might be necessary to remove infected tissue.

Rose thorns can deliver bacteria and fungi into your skin and cause infection. To protect yourself while picking roses or gardening in general, wear protective clothing like gloves.

Gray rot on roses: signs, methods of control and prevention

• 1 Causes and signs of the disease
• 2 How to deal with the disease
• 3 Prevention of gray rot on roses

The rose is considered the queen of flowers, but she is not spared either. various plant diseases. Gray rot, a disease caused by the fungus Botrytis cinerea , can spoil the aesthetic appearance of the buds. If you miss her appearance and do not take appropriate measures, the rose bush will die first, then the entire rose garden. Knowing the signs of the disease, methods of dealing with it and methods of prevention is necessary in order to prevent possible troubles and not be left without roses.

Causes and signs of the disease

Botrytis fungus can infect a wide variety of plants: strawberries, cabbage, grapes and many others. The list of his potential victims includes more than 200 items. Roses are included in this list.

They can become infected from other inhabitants of the garden or garden – the infection spreads through the air, it can be carried by insects on their paws. Often, infection occurs by contact: through garden tools, gardener’s clothes.

Most often, the disease overtakes young and weakened plants. The first to suffer are buds, leaves, then the fungus spreads to stems, pedicels. Gradually, the infection reaches the root system, the plant rots completely.

The presence of the disease can be determined by the following signs:

• medium-sized brown spots with a small depression in the center, which gradually grow;
• a gray smoky coating that covers the plant in the affected areas about a week after the appearance of a brown spot – “fluffs” are fungal spores;
• black oval bodies in places of gray plaque are sclerotia, in this form the fungus “overwinters” on parts of the plant, in the soil.

Concomitant factors are high humidity, a sharp temperature drop. Rainy weather, excessive watering, foggy mornings, a large planting density that does not allow the soil to dry out quickly – such conditions are most favorable for the occurrence of gray rot.

The end of summer is the time when these factors are observed most often. It is at this time that roses usually fall ill.

If they leave untreated in the winter, the disease will begin to actively develop under cover and will have time to destroy the entire rose garden or a couple of rose bushes before spring.

Measures taken in time will allow you to save roses, and they will delight you with their beauty for a long time to come.

How to deal with the disease

Signs of gray mold on roses are so specific that it is almost impossible to confuse the disease with something else. Having discovered the disease, you need to immediately begin to fight it.

1. Remove damaged plant parts first. It is better to capture areas with a “margin” in order to be sure that the fragments of rose bushes affected by the fungus are completely removed. It is necessary to dispose of the diseased parts of the plant correctly; it is impossible to leave them in the garden.
2. Treat rose bushes with fungicides. It is advisable not only to spray, but also to water the plants with medicinal solutions. If necessary, the treatment will have to be repeated, guided by the instructions for the specific preparation.

The following agents are used to combat gray mold on roses:

• “Fundazol”;
• “Phytodoctor”;
• “Gamair”;
• “Fitosporin-M”;
• “Euparen-multi”;
• Alirin-B;
• Switch.

From folk remedies, infusions of horsetail, garlic, mustard, solutions of potassium permanganate, laundry soap, and soda have proven themselves well. They are cheaper than specialized chemistry, but not as effective. It is advisable to use them for preventive, but not therapeutic purposes. Excessive savings can result in the fact that gray rot will destroy the entire rose garden and the losses will be more tangible than spending on the purchase of agrochemicals.

Prevention of gray rot on roses

If you want to save money, but keep your roses, you need to take preventive measures:

• Do not plant roses too often.
• Choose well-ventilated areas of the garden for the rose garden.
• Keep plants most susceptible to gray rot away from rose bushes. These plants include garden strawberries, grapes, cabbage, tomatoes.
• Feed your roses with a fertilizer containing manganese salts. This will make them more resistant to fungal diseases.
• Periodically treat plants with folk remedies or agrochemicals that have an antifungal effect. The processing mode depends on the selected medium. You will find this information on the packages with the drug. If you use folk remedies, treat rose bushes with them once every one to two weeks.
• Etch cuttings before rooting in solutions of “Maxim”, “Baktofit”, “Vitaros”.
• Do not use planting material that you are not sure about, that has visible damage.
• Discard dead plants promptly.
• Do not leave plant debris in the garden.
• Mulch with needles, nutshells, tree bark.

There are no varieties of roses that are absolutely resistant to gray mold. It is noticed that most often she suffers from flowers that have a light pink color.

Roses, despite their thorns and all their splendor, are fragile and defenseless. They are threatened by various diseases, including gray rot. Its main symptom is a smoky coating formed by spores of the fungus. If adequate measures are not taken, the rose bush will die. The use of modern agricultural chemistry will help save the rose garden. Do not neglect preventive measures.

video and instruction for beginners

Most modern varieties of garden roses cannot tolerate too low temperatures. Therefore, with the approach of frost, the grower should think about how to prune roses for the winter and build a shelter for them. Practical advice from experienced gardeners and videos will help you understand all the intricacies of the process, avoid gross mistakes that lead to the death of even the most hardy varieties.

Complete pruning of shoots in autumn should not be done

Reason and timing of pruning roses

According to experienced gardeners, it is not advisable to do a full pruning of shoots in autumn for the following reasons:

1. The procedure takes a lot of energy from the bush, it goes into the winter weakened.
2. Roses can become infected through cuts.
3. Plants that have not been pruned before winter grow green mass faster and form buds.

   Infections penetrate into shoot tissues through cuts

Selective pruning is done in autumn, removing:

• old, diseased, withered shoots;
• Branches too long and stiff to interfere with cover;
• “wen” that did not have time to fully mature;
• buds with part of the shoot;
• leaves with petioles.

More information about preparing rose bushes for cold weather is described in the video.

If there are too many roses in the area, you can not completely remove all the foliage. It is enough to cut them only from the lower branches to provide better air access to the base. Only blackened leaf plates of diseased plants are subject to mandatory pruning. After the procedure, the foliage is completely removed from under the bush. It won’t work as a cover.

Leaves are removed from under the bush

Autumn pruning is carried out in the middle or end of October, when there will be no increase in temperature. If the green shoots are removed earlier, then at the first warming they will start to grow, and the plant will not have time to prepare for wintering.

To prevent infection, shortened shoots are treated at the cut points with garden pitch. Thin branches can be greased with brilliant green.

Prepared perennials are treated twice:

• immediately after trimming with a solution of ferrous sulfate (3%) or any other antifungal agent;
• 3% solution of Bordeaux mixture immediately before shelter.

Terms and options for sheltering roses

It is necessary to cover rose bushes for the winter in 2 stages.

1. From mid-September to mid-October, the shoots bend down to the ground. After a cold snap, they will become rigid, during the procedure they may break or get damaged.
2. In early November, when the thermometer drops to -3-7°C, the bushes are covered. If you do this earlier, the plants will spit out under the covering material.

How to use construction geotextile to cover ground cover roses, see video.

Dry shelter is considered the best option. Instruction for beginners on its installation:

1. In mid-autumn, the shoots are bent to the ground and fixed with staples. If plants need to be tied to a support, only synthetic ropes are used. Natural fibers will rot over the winter and harm the plant. To prevent the shoots from getting wet, lay a litter under them. It is made from foam or plastic bottles.
2. After frost, before snow falls, a metal or wooden frame is installed above the bushes. In the Middle lane, in the northern regions, it is replaced with spruce branches.

   Bucket frame

3. The structure is covered with agrofibre (spunbond or lutrasil) folded in 2 layers. The edges of the material are pressed with bricks or earth is thrown over them.

The following instruction will help beginners to save the rose garden from destruction. Another controversial issue among gardeners is whether it is possible to cover roses with plastic wrap. Yes, but only if you open it for ventilation until the end of autumn, otherwise condensation will accumulate under it and the shoots will rot.

In the spring, when the danger of frost has passed, the shelter is gradually removed. After that, pruning is carried out, focusing on the state of the perennial.

Hilling rose bushes

Some flower growers advise, instead of shelter, to pile bushes high with earth mixed with sunflower or rice husks. This method is effective only in areas where dry warm weather immediately sets in after a short winter.