Pulmonary sporotrichosis in Oklahoma in susceptibilities in vitro.
Six cases of pulmonary sporotichosis were observed in 2 institutions in Oklahoma City, Okla. Three of the patients were treated with iodides with or without surgery. Although one patient required a second course of iodides, the patients have remained well after at least 34 months of follow-up. Three patients treated with amphotericin B, single course as well as multiple courses, and other antifungal agents (hydroxystilbamidine and miconazole) have all relapsed. These cases and a reviewed of more than 40 cases of pulmonary sporotrichosis susceptibilities of Sporothrix schenckii that we observed in vitro suggest that amphotericin B is not an effective agent for the treatment of pulmonary sporotrichosis. It is our opinion that the treatment of choice for pulmonary sporotrichosis is a supersaturated solution of potassium iodide. If the patient is allergic to the medication or fails to respond, then a combination of amphotericin B plus flucytosine may be tried.
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D066298:In Vitro Techniques; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008825:Miconazole / Q000627:therapeutic use; D008875:Middle Aged; D009825:Oklahoma; D011193:Potassium Iodide / Q000627:therapeutic use*; D013175:Sporothrix / Q000187:drug effects; D013174:Sporotrichosis / Q000188:drug therapy* / Q000453:epidemiology; D013266:Stilbamidines / Q000627:therapeutic use
D000935:Antifungal Agents; D013266:Stilbamidines; D011193:Potassium Iodide; D008825:Miconazole; D000666:Amphotericin B