TREATMENT OF LYMPHOCUTANEOUS AND VISCERAL SPOROTRICHOSIS WITH FLUCONAZOLE

Thirty patients with documented sporotrichosis were treated with 200-8 00 mg of fluconazole daily, Fourteen patients had lymphocutaneous infe ction; only five (36%) of these patients had any underlying illnesses. Sixteen patients had osteoarticular or visceral sporotrichosis; 12 (7 5%) of these patients had underlying diseases, mostly alcoholism, diab etes mellitus, and chronic obstructive pulmonary disease, Eleven of th e 30 patients had relapsed after prior antifungal therapy, Most patien ts were treated with 400 mg of fluconazole; however, four received 200 mg of fluconazole daily for the entire course, and four received 800 mg of fluconazole daily for a portion of their therapy or for the enti re course of therapy, Fluconazole therapy cured 10 (71%) of 14 patient s with lymphocutaneous sporotrichosis, However, only five (31%) of 16 patients with osteoarticular or visceral sporotrichosis responded to t herapy; the conditions of two of these five patients improved only, an d there was no documented cure of their infections. With the exception of alopecia in five patients, toxic effects were minimal. Fluconazole is only modestly effective for treatment of sporotrichosis and should be considered second-line therapy for the occasional patient who is u nable to take itraconazole.