Treatment of sporotrichosis
- Carol A Kauffman, MD
Carol A Kauffman, MD
- Section Editor — Fungal Infections
- Professor of Internal Medicine
- University of Michigan Medical School
- Veterans Affairs Ann Arbor Healthcare System
- Section Editors
- Kieren A Marr, MD
Kieren A Marr, MD
- Section Editor — Compromised Host Infections; Fungal Infections
- Professor of Medicine and Oncology
- Johns Hopkins University School of Medicine
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
Sporotrichosis is a subacute to chronic infection caused by the dimorphic fungus Sporothrix schenckii. Infection usually involves cutaneous and subcutaneous tissues but can occasionally occur in other sites, primarily in immunocompromised patients. Activities associated with the development of sporotrichosis include landscaping, rose gardening, and other activities that involve inoculation of soil through the skin.
Treatment of sporotrichosis varies with the type of disease . Since most manifestations are subacute to chronic and localized, oral antifungal agents are usually preferred. The agent of choice is itraconazole . The rare cases of life-threatening, visceral, or disseminated infection require therapy with intravenous amphotericin B, which is also used in patients who do not respond to itraconazole.
The treatment of the various manifestations of sporotrichosis will be reviewed. The approach is consistent with the 2007 Infectious Diseases Society of America clinical practice guidelines for the management of sporotrichosis (table 1) .
The basic biology, epidemiology, clinical manifestations, and diagnosis of sporotrichosis are discussed separately. (See "Basic biology and epidemiology of sporotrichosis" and "Clinical features and diagnosis of sporotrichosis".)
CHOICE OF ANTIFUNGAL AGENT
The choice of antifungal agent in patients with sporotrichosis is limited. In vitro susceptibility studies and clinical experience support itraconazole as the treatment of choice for patients with most forms of localized sporotrichosis, and amphotericin B as the preferred treatment for patients who are severely ill [3-5]. Fluconazole and ketoconazole are poor second-line choices [6-8].To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CHOICE OF ANTIFUNGAL AGENT
- LYMPHOCUTANEOUS AND CUTANEOUS SPOROTRICHOSIS
- PULMONARY SPOROTRICHOSIS
- Severe or life-threatening disease
- Mild to moderate disease
- OSTEOARTICULAR SPOROTRICHOSIS
- MENINGEAL SPOROTRICHOSIS
- DISSEMINATED SPOROTRICHOSIS
- Treatment of HIV-infected patients
- TREATMENT OF PREGNANT WOMEN
- TREATMENT OF CHILDREN
- SUMMARY AND RECOMMENDATIONS