Adjuvant hyperbaric oxygen therapy reduces the duration of sporotrichosis treatment

Sporotrichosis is a subcutaneous mycosis caused by Sporothrix spp., typically acquired through traumatic inoculation of fungal spores from soil, plants and infected cat scratches. The disease manifests in various clinical forms, including lymphocutaneous, ocular, bone, and disseminated infections. Standard treatment relies on prolonged administration of antifungals such as itraconazole, terbinafine, and potassium iodide, often requiring months for complete resolution. Moreover, treatment challenges include slow clinical response, recurrence, and potential drug toxicity. Hyperbaric oxygen therapy has been investigated as a potential adjuvant for invasive fungal infections due to its antimicrobial properties, enhanced tissue oxygenation, and immunomodulatory effects, which may contribute to improved healing and therapeutic outcomes.

Patients with a confirmed diagnosis of cutaneous/lymphocutaneous sporotrichosis were divided into two groups to receive either itraconazole or itraconazole plus hyperbaric oxygen therapy. The primary outcomes were time to cure and therapeutic response. The intervention group was assessed weekly through clinical parameters and photographic records, and the control group was assessed monthly.

Patients who received hyperbaric oxygen therapy experienced a much shorter healing time than those who did not. The average time until a cure was 208.53 days in the itraconazole group compared to 57.54 days in the itraconazole plus hyperbaric oxygen therapy group. Patients in the Hyperbaric oxygen therapy group received an average of 18.23 hyperbaric sessions and were 65 times more likely to achieve faster healing than those who did not. Notably, with each additional year of age, the chances of rapid healing decreased by 2%.

Our findings suggest that adjuvant hyperbaric oxygen therapy significantly accelerates the healing of fixed cutaneous/lymphocutaneous sporotrichosis. The results also highlight hyperbaric oxygen therapy´s potential to enhance treatment efficacy and reduce the burden of prolonged antifungal therapy. These results support further investigation of this valuable adjunctive treatment in the management of sporotrichosis.