TREATMENT OF SPOROTRICHOSIS WITH ITRACONAZOLE

PURPOSE: To describe the clinical presentation and outcomes of treatme nt with itraconazole in patients with sporotrichosis. METHODS: A cultu re for Sporothrix schenckii or compatible histopathology was required for inclusion in the study. Patients with both cutaneous and systemic sporotrichosis were treated. Patients received from 100 to 600 mg of i traconazole daily for 3 to 18 months. Patients were classified as resp onders or nonresponders. Responders were further classified as remaini ng on treatment, relapsed, or free of disease. Nonresponders included patients who failed to respond or progressed during treatment with itr aconazole. RESULTS: Twenty-seven patients (mean age: 53 years) were tr eated with 30 courses of itraconazole. Diabetes mellitus and alcoholis m were present in eight and seven patients, respectively. Sites of inv olvement included lymphocutaneous alone in 9 patients, articular/osseo us in 15 (multifocal in 3), and lung in 3. Prior therapy was unsuccess ful in 11 patients. Among the 30 courses, there were 25 responders and 5 nonresponders. All 5 nonresponders received at least 200 mg daily o f itraconazole for durations that ranged from 6 to 18 months. Of the 2 5 responders, 7 relapsed 1 to 7 months after treatment durations of 6 to 18 months. Of the 7 who relapsed, 2 are responding to a second cour se. One responder was lost to follow-up after 10 months of treatment w ith itraconazole. Of the re 17 responders, 3 remain on treatment, and 14 are free of disease over follow-up durations of 6 to 42 months (mea n: 17.6 months). Itraconazole was well tolerated with few side effects noted. CONCLUSIONS: These results document the efficacy of itraconazo le in the treatment of cutaneous and systemic sporotrichosis.