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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Sporotrichosis medical therapy

Introduction

Overview

Overview

Because spontaneous resolution in cases of sporotrichosis is a rarity, the majority of patients require treatment. The recommended treatment regimens are largely empirical and predominantly based upon retrospective evaluations, case study reports, and nonrandomized control trials. The predominant therapy for sporotrichosis is itraconazole, which is used as the primary treatment in immunocompetent patients, and as a suppressive therapy in immunocompromised patients. The primary line of treatment for immunocompromised patients is amphotericin B.

Treatment

Treatment

Because spontaneous resolution in cases of sporotrichosis is a rarity, the majority of patients require treatment. The recommended treatment regimens are largely empirical and predominantly based upon retrospective evaluations, case study reports, and nonrandomized control trials.[1] The chart below outlines the effective treatment methods based upon the form of sporotrichosis displayed by an infected human host.

Form Primary Line of Treatment Alternative Treatment Remarks/Other
Uncomplicated cutaneous Continue treatment for 2-4 weeks after lesions resolve.
Osteoarticular For a total of 12 months, switch to Itraconazole after resolution/end of treatment.
Pulmonary Treat less sever cases with a 12 month regimen of Itraconazole.
Meningeal
  • Limposomal amphotericin B 3-5 mg/kg IV qd THEN
  • Itraconazole 200 mg PO bid
 Precise length of amphotericin B treatment varies. Suppressive treatment with Itraconazole is necessary.
Dissimated
  • Limposomal amphotericin B 3-5 mg/kg IV qd THEN
  • Itraconazole 200 mg PO bid.
 Continue amphotericin B treatment until patient shows marked improvement for a minimum of 12 months. Suppressive treatment with Itraconazole is necessary.
Sporotrichosis in pregnant women
  • Treat with limposomal amphotericin B 3-5 mg/kg IV qd OR
  • Deoxycholate amphotericin B 0.7-1 mg/kg IV qd only for severe cases of sporotrichosis OR
  • In cases of uncomplicated cutaneous, treat with only hyperthermia.
 It is preferable to defer treatment in uncomplicated cases.
Sporotrichosis in Children
  • Itraconazole 6-10 mg PO qd to a max of 400 mg PO qd for mild cases OR
  • Deoxycholate amphotericin B 0.7-1 mg/kg IV qd for severe cases
  • SSKI increasing doses equivalent to half the adult dose, continuing treatment for 2-4 weeks after resolution of symptoms.

[1] [2]

References

References

  1. ↑ 1.0 1.1 Kauffman CA, Bustamante B, Chapman SW, Pappas PG, Infectious Diseases Society of America (2007). “Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America”. Clin Infect Dis. 45 (10): 1255–65. doi:10.1086/522765. PMID 17968818.
  2. ↑ Barros MB, de Almeida Paes R, Schubach AO (2011). “Sporothrix schenckii and Sporotrichosis”. Clin Microbiol Rev. 24 (4): 633–54. doi:10.1128/CMR.00007-11. PMC 3194828. PMID 21976602.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alison Leibowitz [2]