Treatment of pulmonary sporotrichosis.

Pulmonary infection with Sporothrix schenckii is extremely rare. The small number of reported cases and lack of comparative clinical trials make assessment of treatment regimens difficult. Three modalities should be considered: Saturated solution of potassium iodide (SSKI), amphotericin B, and resective surgery. Available data suggest that SSKI is unlikely to be successful in cavitary disease or disease in immunocompromised hosts. Amphotericin B alone has been successfully used to cure cavitary pulmonary sporotrichosis, but overall cure rates probably are no higher than 50%, and the probability of cure in bilateral apical disease is dismal. Surgical resection has been successful when used alone in a small number of cases. The highest cure rates (70% to 80%) appear to be a result of management with amphotericin B or SSKI combined with resective pulmonary surgery. The dosage and duration of amphotericin B or SSKI to be used in conjunction with surgical resection is unknown.