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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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