Itraconazole therapy in lymphangitic and cutaneous sporotrichosis

Epidemiology of sporotrichosis: A study of 304 cases in Brazil

“…30 Interestingly enough, we found no statistical difference in our study between the numbers of , and host immune response (localized sporotrichosis has been considered a clinical form that occurs for patients with certain immunity against the fungus, whereas lymphangitic disease develops for patients who have not been in previous contact with the pathogen). 3,26,30,[47][48][49][50] The latter fact favors Rio Grande do Sul, Brazil, as an endemic area of sporotrichosis, where patients are exposed over years to small amounts of conidia and become resistant to the disease, or present with a clinical manifestation of reinfection, as fixed cutaneous disease. Another factor that has been pointed out by some authors is the influence of the climate on the predominance of one form over the other.…”

Antifungal Agents

“…Itraconazole can be administered for step-down therapy but it is not ideal for the treatment of mycoses involving the central nervous system due to its poor central nervous system penetration. 25,37,38,[176][177][178][179] Although it has an indication for the treatment of cryptococcosis, it is not a preferred agent for consolidation or maintenance therapy given its poor cerebrospinal fluid penetration and higher reported failure rate. 39 Itraconazole has been shown to be effective for the treatment of oropharyngeal, esophageal, and vaginal candidiasis but it is not currently recommended as firstline therapy for these infections.…”

Sporotrichosis Treatment: Overview and Update

“…Most of these reports were published between 1986 and 1999, usually with limited follow-up time to detect relapses. In the first prospective and open-label study, Restrepo et al [24] cured all 17 patients with subcutaneous sporotrichosis by administering 100 mg of itraconazole daily for 3 to 6 months. However, in subsequent studies some patients required a higher dose of itraconazole.…”

“…Reported adverse events possibly related to itraconazole during treatment of subcutaneous sporotrichosis are nausea, vomiting, elevation of transaminases and bilirubin levels, headache, epigastralgia, and peripheral edema [24][25][26]. Monitoring of liver function is recommended in all patients receiving itraconazole, because some rare cases of serious hepatotoxicity have been observed in patients receiving this drug to treat other fungal infections.…”