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Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission
Although rare, disseminated sporotrichosis is increasing in several countries. Despite its limiting toxic potential, amphotericin B is the only intravenous antifungal available to treat severe sporotrichosis. We aimed to describe the effectiveness and safety of amphotericin B treatment for severe sp...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144044/ https://www.ncbi.nlm.nih.gov/pubmed/35628725 http://dx.doi.org/10.3390/jof8050469 |
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author | Fichman, Vivian Freitas, Dayvison Francis Saraiva do Valle, Antonio Carlos Francesconi de Souza, Rogerio Valls Curi, André Luiz Land Valete-Rosalino, Cláudia Maria de Macedo, Priscila Marques Varon, Andréa Gina Figueiredo-Carvalho, Maria Helena Galdino Almeida-Silva, Fernando Zancopé-Oliveira, Rosely Maria Oliveira, Raquel de Vasconcelos Carvalhaes Almeida-Paes, Rodrigo Gutierrez-Galhardo, Maria Clara |
author_facet | Fichman, Vivian Freitas, Dayvison Francis Saraiva do Valle, Antonio Carlos Francesconi de Souza, Rogerio Valls Curi, André Luiz Land Valete-Rosalino, Cláudia Maria de Macedo, Priscila Marques Varon, Andréa Gina Figueiredo-Carvalho, Maria Helena Galdino Almeida-Silva, Fernando Zancopé-Oliveira, Rosely Maria Oliveira, Raquel de Vasconcelos Carvalhaes Almeida-Paes, Rodrigo Gutierrez-Galhardo, Maria Clara |
author_sort | Fichman, Vivian |
collection | PubMed |
description | Although rare, disseminated sporotrichosis is increasing in several countries. Despite its limiting toxic potential, amphotericin B is the only intravenous antifungal available to treat severe sporotrichosis. We aimed to describe the effectiveness and safety of amphotericin B treatment for severe sporotrichosis. Clinical records of patients with disseminated sporotrichosis at a reference center were reviewed. This study included 73 patients. Most (53.4%) were men and non-white. HIV coinfection was the main comorbidity (52.1%). Most reported contact with cats (76.7%). Sporothrix brasiliensis was the causative species. Affected sites were skin (98.6%), osteoarticular system (64.4%), upper airway (42.5%), central nervous system (20.5%), eyes (12.3%), and lungs (8.2%). Median doses of amphotericin B used were 750 mg and 4500 mg for deoxycholate and lipid complex formulations, respectively. Amphotericin B discontinuation occurred in 20.5% due to adverse events, mainly azotemia. The outcomes included cure (52.1%), death due to sporotrichosis (21.9%), death due to other causes (9.6%), and loss to follow-up (8.2%). Survival analysis showed an association between cure and the absence of bone, upper airway, and central nervous system involvement. Amphotericin B is the first-choice treatment for disseminated sporotrichosis; however, the severity of systemic dissemination might predict its response. Favorable clinical results depend on prompt diagnosis, investigation of fungal dissemination, and early therapy initiation. |
format | Online Article Text |
id | pubmed-9144044 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91440442022-05-29 Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission Fichman, Vivian Freitas, Dayvison Francis Saraiva do Valle, Antonio Carlos Francesconi de Souza, Rogerio Valls Curi, André Luiz Land Valete-Rosalino, Cláudia Maria de Macedo, Priscila Marques Varon, Andréa Gina Figueiredo-Carvalho, Maria Helena Galdino Almeida-Silva, Fernando Zancopé-Oliveira, Rosely Maria Oliveira, Raquel de Vasconcelos Carvalhaes Almeida-Paes, Rodrigo Gutierrez-Galhardo, Maria Clara J Fungi (Basel) Article Although rare, disseminated sporotrichosis is increasing in several countries. Despite its limiting toxic potential, amphotericin B is the only intravenous antifungal available to treat severe sporotrichosis. We aimed to describe the effectiveness and safety of amphotericin B treatment for severe sporotrichosis. Clinical records of patients with disseminated sporotrichosis at a reference center were reviewed. This study included 73 patients. Most (53.4%) were men and non-white. HIV coinfection was the main comorbidity (52.1%). Most reported contact with cats (76.7%). Sporothrix brasiliensis was the causative species. Affected sites were skin (98.6%), osteoarticular system (64.4%), upper airway (42.5%), central nervous system (20.5%), eyes (12.3%), and lungs (8.2%). Median doses of amphotericin B used were 750 mg and 4500 mg for deoxycholate and lipid complex formulations, respectively. Amphotericin B discontinuation occurred in 20.5% due to adverse events, mainly azotemia. The outcomes included cure (52.1%), death due to sporotrichosis (21.9%), death due to other causes (9.6%), and loss to follow-up (8.2%). Survival analysis showed an association between cure and the absence of bone, upper airway, and central nervous system involvement. Amphotericin B is the first-choice treatment for disseminated sporotrichosis; however, the severity of systemic dissemination might predict its response. Favorable clinical results depend on prompt diagnosis, investigation of fungal dissemination, and early therapy initiation. MDPI 2022-04-30 /pmc/articles/PMC9144044/ /pubmed/35628725 http://dx.doi.org/10.3390/jof8050469 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Fichman, Vivian Freitas, Dayvison Francis Saraiva do Valle, Antonio Carlos Francesconi de Souza, Rogerio Valls Curi, André Luiz Land Valete-Rosalino, Cláudia Maria de Macedo, Priscila Marques Varon, Andréa Gina Figueiredo-Carvalho, Maria Helena Galdino Almeida-Silva, Fernando Zancopé-Oliveira, Rosely Maria Oliveira, Raquel de Vasconcelos Carvalhaes Almeida-Paes, Rodrigo Gutierrez-Galhardo, Maria Clara Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission |
title | Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission |
title_full | Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission |
title_fullStr | Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission |
title_full_unstemmed | Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission |
title_short | Severe Sporotrichosis Treated with Amphotericin B: A 20-Year Cohort Study in an Endemic Area of Zoonotic Transmission |
title_sort | severe sporotrichosis treated with amphotericin b: a 20-year cohort study in an endemic area of zoonotic transmission |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144044/ https://www.ncbi.nlm.nih.gov/pubmed/35628725 http://dx.doi.org/10.3390/jof8050469 |
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