Sporotrichosis Treatment & Management

  • Author: Ronald A Greenfield, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Jan 11, 2012
 

Medical Care

Antifungal therapy is the mainstay of treatment for all forms of sporotrichosis.

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Surgical Care

  • Surgical therapy is important in the management of osteoarticular sporotrichosis.
  • Principles of surgical care are the same as for other bone and joint infections. Appropriate drainage of infected joints minimizes joint damage. Appropriate debridement of infected bone enhances the likelihood of eradication of infection with antimicrobial therapy.
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Activity

Patients may perform routine activity as tolerated.

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Contributor Information and Disclosures
Author

Ronald A Greenfield, MD  Professor, Department of Internal Medicine, University of Oklahoma College of Medicine

Ronald A Greenfield, MD is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, Medical Mycology Society of the Americas, Phi Beta Kappa, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology

Disclosure: Pfizer Honoraria Speaking and teaching; Gilead Honoraria Speaking and teaching; Ortho McNeil Honoraria Speaking and teaching; Abbott Honoraria Speaking and teaching; Astellas Honoraria Speaking and teaching; Cubist Honoraria Speaking and teaching; Forest Pharmaceuticals Speaking and teaching

Specialty Editor Board

Pranatharthi Haran Chandrasekar, MBBS, MD  Professor, Department of Internal Medicine, Director of Infectious Disease Fellowship, Harper Hospital, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Thomas M Kerkering, MD  Chief of Infectious Diseases, Virginia Tech Carilion School of Medicine

Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References
  1. Marimon R, Gene J, Cano J, et al. Molecular phylogeny of Sporothrix schenckii. J Clin Microbiol. Sep 2006;44(9):3251-6. [Medline].

  2. Pappas PG, Tellez I, Deep AE, et al. Sporotrichosis in Peru: description of an area of hyperendemicity. Clin Infect Dis. Jan 2000;30(1):65-70. [Medline].

  3. Song Y, Li SS, Zhong SX, Liu YY, Yao L, Huo SS. Report of 457 sporotrichosis cases from Jilin province, northeast China, a serious endemic region. J Eur Acad Dermatol Venereol. Dec 17 2011;[Medline].

  4. Kauffman CA. Sporotrichosis. Clin Infect Dis. Aug 1999;29(2):231-6; quiz 237. [Medline].

  5. Winn RE. A contemporary view of sporotrichosis. Curr Top Med Mycol. 1995;6:73-94. [Medline].

  6. Ramirez J, Byrd RP, Roy TM. Chronic cavitary pulmonary sporotrichosis: efficacy of oral itraconazole. J Ky Med Assoc. Mar 1998;96(3):103-5. [Medline].

  7. Silva-Vergara ML, Maneira FR, De Oliveira RM, et al. Multifocal sporotrichosis with meningeal involvement in a patient with AIDS. Med Mycol. Mar 2005;43(2):187-90. [Medline].

  8. Freitas DF, de Siqueira Hoagland B, Do Valle AC, Fraga BB, de Barros MB, de Oliveira Schubach A, et al. Sporotrichosis in HIV-infected patients: report of 21 cases of endemic sporotrichosis in Rio de Janeiro, Brazil. Med Mycol. Aug 23 2011;[Medline].

  9. Kauffman CA, Pappas PG, McKinsey DS, et al. Treatment of lymphocutaneous and visceral sporotrichosis with fluconazole. Clin Infect Dis. Jan 1996;22(1):46-50. [Medline].

  10. Sharkey-Mathis PK, Kauffman CA, Graybill JR, et al. Treatment of sporotrichosis with itraconazole. NIAID Mycoses Study Group. Am J Med. Sep 1993;95(3):279-85. [Medline].

  11. Chapman SW, Pappas P, Kauffmann C, et al. Comparative evaluation of the efficacy and safety of two doses of terbinafine (500 and 1000 mg day(-1)) in the treatment of cutaneous or lymphocutaneous sporotrichosis. Mycoses. Feb 2004;47(1-2):62-8. [Medline].

  12. [Guideline] Kauffman CA, Bustamante B, Chapman SW, et al. Clinical practice guidelines for the management of sporotrichosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. Nov 15 2007;45(10):1255-65. [Medline]. [Full Text].

  13. Lyon GM, Zurita S, Casquero J, et al. Population-based surveillance and a case-control study of risk factors for endemic lymphocutaneous sporotrichosis in Peru. Clin Infect Dis. Jan 1 2003;36(1):34-9. [Medline].

  14. Prentice AG, Glasmacher A. Making sense of itraconazole pharmacokinetics. J Antimicrob Chemother. Sep 2005;56 Suppl 1:i17-i22. [Medline].

  15. Smego RA Jr, Castiglia M, Asperilla MO. Lymphocutaneous syndrome. A review of non-sporothrix causes. Medicine (Baltimore). Jan 1999;78(1):38-63. [Medline].

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This photo depicts cutaneous disseminated sporotrichosis in a patient with AIDS before and after therapy. (Courtesy of Leonard N. Slater, MD)
Photomicrograph that shows the conidiophores and conidia of the fungus Sporothrix schenckii. Photo from CDC Public Health Image Library.
Lymphocutaneous sporotrichosis.
Lymphocutaneous sporotrichosis.
Lymphocutaneous sporotrichosis.
Cigar-shaped yeast of Sporothrix schenckii in tissue macrophages in a biopsy specimen.
 
 
 
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