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Treatment of sporotrichosis

Carol A Kauffman, MD
Section Editors
Kieren A Marr, MD
Sheldon L Kaplan, MD
Deputy Editor
Jennifer Mitty, MD, MPH


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 [1]. Since most manifestations are subacute to chronic and localized, oral antifungal agents are usually preferred. The agent of choice is itraconazole [2]. 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) [3].

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".)


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].

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Literature review current through: Nov 2017. | This topic last updated: May 17, 2016.
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