Efficacy of a poly-aggregated formulation of amphotericin B in treating systemic sporotrichosis caused by Sporothrix brasiliensis.

In severe cases of sporotrichosis, it is recommended to use amphotericin B deoxycholate (D-AMB) or its lipid formulations and/or in association with itraconazole (ITC). Our aim was to evaluate the antifungal efficacy of a poly-aggregated amphotericin B (P-AMB), a nonlipid formulation, compared with D-AMB on systemic sporotrichosis caused by Sporothrix brasiliensis. In vitro assays showed that Sporothrix schenckii sensu stricto and S. brasiliensis yeast clinical isolates were susceptible to low concentrations of P-AMB and D-AMB. Although P-AMB presented a higher minimal inhibitory concentration (MIC) compared to D-AMB, its cytotoxic effect on renal cells and erythrocytes was lower. For the in vivo assays, male BALB/c mice were intravenously infected with S. brasiliensis yeasts, and P-AMB or D-AMB was administered 3 days post-infection. The efficacy of five therapeutic regimens was tested: intravenous monotherapy with P-AMB or D-AMB, intravenous pulsed-therapy with P-AMB or D-AMB, and intravenous therapy with P-AMB, followed by oral ITC. These treatments increased murine survival and controlled the fungal burden in the liver, spleen, lungs, and kidneys. However, only D-AMB monotherapy or the pulsed-therapies with D-AMB or P-AMB led to 100% survival of the mice 45 days post-infection; only pulsed administration of D-AMB was able to control the fungal load in all organs 45 days post-infection. Accordingly, the histopathological findings showed reductions in the fungal burden and inflammatory reactions in these treatment regimens. Together, our results suggest that the P-AMB formulation could be considered as an alternative drug to D-AMB for treating disseminated sporotrichosis.

Infectious arthritis as the single manifestation of sporotrichosis: Serology from serum and synovial fluid samples as an aid to diagnosis

En la mayoría de las veces, la esporotricosis es una infección cutánea,granulomatosa, crónica y benigna. De modo más raro, la enfermedad puedeafectar las articulaciones. El comprometimiento articular en general secaracteriza por monoartrite sin síntomas sistémicos con presentación clínicahabitual de lesiones cutáneas y con frecuencia despunta en las personasinmunodeprimidas. El caso descrito es de una paciente sana que presentóartritis en la rodilla sin lesiones cutáneas, con el diagnostico de esporotricosisy que fue tratada con itraconazol oral. En este caso se concluye que lasorología es una herramienta valiosa para el diagnóstico de la artritis sinlesiones cutáneas producida por el hongo Sporothrix schenckii(AU)

Sporotrichosis is a generally cutaneous, granulomatous, chronic and benigninfection. Less frequently the disease may affect the joints. Articularinvolvement is usually characterized by monoarthritis in the absence ofsystemic symptoms, generally preceded by skin lesions, and frequently affectsimmunosuppressed individuals. We describe here the case of a healthy patientpresenting knee arthritis without skin lesions, diagnosed as sporotrichosis, andtreated with oral itraconazole. Serology used in this case was an invaluabletool for the diagnosis of sporotrichosis arthritis lacking skin lesions(AU)